The laboratory service of medical organizations subordinated to the Ministry of Health of the Russian Federation bears a huge burden during the COVID-19 pandemic. Both etiological diagnostics and general laboratory methods are aimed at early detection of the disease, the most effective provision of medical care to patients in the acute period of the disease, and determination of the risks of complications in the post-covid period. For 2 years of the pandemic, the laboratory service has come a hard way and gained invaluable professional and organizational experience in emergency conditions. Through joint efforts, with the close-knit work of all employees of laboratories, manufacturers, suppliers, healthcare organizers, in a short period, the etiological diagnosis of COVID-19 was established in all constituent entities of the Russian Federation, the equipment park was updated and supplemented, and additional capacities were deployed. At the same time, the pandemic has exposed and exacerbated the challenges in laboratory services that we will have to address in the near future.