This study analyzed laboratory test utilization in a hospital setting to identify overuse and underuse. The results showed that 20.6% of tests were overused while 44.8% were underused. Staff surveys found a lack of awareness around appropriate test ordering. Critical care had the highest canceled test reordering rate while outpatients had the lowest. The discussion concluded more education is needed for clinicians on test selection and utilizing laboratory physicians for consultations could improve practices and reduce errors. Limitations included the single-center design. In summary, this study evaluated laboratory test utilization, identified areas for improvement, and suggested strategies involving laboratory physicians could enhance appropriateness and patient safety.