Bengaluru: For Bengaluru-based techie Sumukh S, blood tests used to be a transactional matter. He would compare prices across apps, check availability and book whichever lab seemed cheapest or quickest that day. That changed about two years ago, after a friend recommended Orange Health Labs. Since then, he says, the app has become his default option, because of its agility. “I’ve had phlebotomists arrive within half an hour [to draw blood],” he told Mint. The reports also came in quickly. “The entire thing gets done within half a day.”
That promise of speed sits at the heart of Orange Health’s ambition. The Bengaluru-headquartered upstart is trying to turn diagnostics into an on-demand consumer service. It promises home sample collection in under 60 minutes and report delivery within six hours.
But for all that, Orange Health still has a long way to go. While its overall revenue figure is creditable, it is still a drop in the ocean for Dr Lal PathLabs, which recorded ₹2,763 crore revenue in FY26, up 12% from ₹2,461 crore in FY25. As for samples, the Gurugram-headquartered company collected 86 million in FY25, according to its annual report, or around 7.1 million a month.
Well begun is not quite half done in this case.
The convenience factor
Orange Health Labs was conceived inside health-tech platform Practo, where co-founders Tarun Bhambra and Dhruv Gupta worked together for nearly four years.
Bhambra had earlier worked at ITC Ltd as an operations manager, spent time at McKinsey & Company and later invested in healthcare startups. Gupta, meanwhile, had already built and exited multiple companies, including social platform DesiMartini, which was acquired by HT Media, and eyewear platform GKB Online. He had also built a personalized nutrition and fitness platform that was later acquired by Practo.
At Practo, the two founders found themselves deep inside the messy workings of India’s healthcare system, closely observing how consumers behaved across primary care. Over time, one insight that stood out was that consumers consistently gravitated towards products that offered convenience with predictability, not just in healthcare but across categories.
“The companies that won were the ones delivering a highly predictable experience. Convenience matters, but convenience plus predictability is what really wins,” Gupta explains, pointing to companies like Uber, Ola, Swiggy and Urban Company.
Diagnostics is a business that depends on execution at every step, from sample collection and logistics to report quality and turnaround time. But once an order was placed, customers often had little visibility into what happened next. “If something went wrong, even we would struggle to figure out what had happened to the sample,” Bhambra says. The founders quickly realized it was an opaque business completely lacking the predictability of e-commerce.
“Diagnostics was one of the last large healthcare categories still operating with poor customer experience, and Orange Health saw the gap,” says Ashish Bhatia, founder and chief executive officer (CEO), India Accelerator and an investor in healthcare startups.
A fragmented market
For all that, diagnostics has long been one of the most attractive businesses in Indian healthcare. Publicly listed companies such as Dr Lal PathLabs and Metropolis Healthcare command premium valuations, often trading at revenue multiples more commonly associated with high-growth startups.
The reason, founders and investors say, is because diagnostics is a high-margin business operating in a market that remains deeply underpenetrated despite years of growth. India’s diagnostics market is expected to grow around 12% every year over the next five years, reaching an estimated $15-16 billion in size, according to a 2025 report by CareEdge Ratings.
And yet, there are only a handful of diagnostics companies with a revenue of over ₹1,000 crore. Dr Lal PathLabs remains the largest ( ₹2,763 crore revenue in FY26), followed by Metropolis Healthcare at around ₹1,646 crore (FY26), and Agilus Diagnostics at over ₹1,400 crore (FY25). Most others are below the ₹1,000-crore mark, including Thyrocare Technologies, Vijaya Diagnostic Centre and Krsnaa Diagnostics. The fragmented nature of the industry, with thousands of regional labs and neighbourhood operators, has historically made national scale difficult to achieve.
For decades, diagnostics in India has largely been a neighbourhood business. Most companies built dominance in small catchment areas, operating a handful of centres in specific cities rather than creating national networks. That is still true today, to a large extent. As of 2024, Dr Lal’s market share in its core geography of North India stood at just 5.5%, and Metropolis’s market share in West India, which contributes 50% of its sales, is a mere 2.7%, according to a report by Axis Capital.
The rise of digital diagnostics platforms added another layer of complexity. Companies such as Tata 1mg and PharmEasy helped push home collection into the mainstream, particularly after the covid-19 pandemic, but the category also became heavily discount-driven. Consumers got used to free home collection, aggressive offers and sharply priced blood tests, making profitability harder to sustain.
Unlike walk-in centres where patients come to the lab, home collection requires companies to manage fleets of phlebotomists moving across cities while maintaining utilization and turnaround times.
This is where the Orange Health founders believed they could excel. They believed the diagnostics domain was primed for disruption. Their core idea was to make reports available quickly.
The need for speed
Most traditional diagnostics companies operate on a batch-processing model. Instead of immediately routing a sample to the laboratory, samples from multiple patients are first collected and aggregated at a common point before being sent together in batches. While this improves operational efficiency and lowers logistics costs, it also adds delays, since samples spend more time moving through the network before reaching the lab.
Orange rebuilt that flow from scratch using what the founders describe as “continuous flow” systems. The idea was that a sample should never sit idle. From the moment blood is drawn, the sample begins moving continuously towards the laboratory through a network of micro hubs spread across the city. Instead of phlebotomists waiting at common handoff points, Orange created a system where a phlebotomist drops the sample at a secure hub and immediately moves to the next collection. Another logistics layer pulls the sample back to the lab independently.
Orange claims every sample within a 500 sq. km radius reaches its laboratory within 180 minutes of collection. Patient registration, scanning and tagging are completed at home itself, allowing samples to move directly into machines without waiting in queues. The convenience behaviour quick commerce is inducing in grocery is now extending to all services, says Pankaj Makkar, managing director, Bertelsmann India Investments.
The company’s thesis also rests on challenging one of diagnostics’ oldest assumptions: that most tests need to happen early in the morning after fasting.
Bhambra argues this misconception was built around operational convenience rather than actual medical necessity. “Out of nearly 3,000 tests, only four really require fasting,” he says.
Dr Zeba Ali, Head of Department (Laboratory), Paras Health, Gurugram, says that broadly, that claim is accurate. “In clinical practice, fasting is typically recommended only for a limited set of investigations such as fasting blood glucose, lipid profile, and a few specialised metabolic assessments. Most commonly prescribed tests, including complete blood count, thyroid profile, liver and kidney function tests, can generally be performed without fasting,” she says.
Just a gimmick?
But it’s not as if the others are tortoises. Several labs now promise reports within hours. Metropolis says it delivers most reports within 4-6 hours, although its website shows a turnaround time of 24 hours. For Tata 1mg, faster delivery is often positioned as a paid add-on rather than the standard experience. For instance, the standard delivery time for a CBC report is 12 hours, but delivery within seven hours is available for an additional ₹49. Pharmeasy and Dr Lal PathLabs offer 12-hour standard delivery.
Moreover, say industry pioneers, speed alone is not enough. “‘Instant’ means it gets attention. But speed matters only in 20% of tests that are related to acute care. For the remaining 80% speed does not matter because they are related to chronic illness,” says Dr A. Velumani, founder of diagnostic chain Thyrocare Technologies.
Ameera Shah, Promoter and executive chairperson of Metropolis Healthcare Limited, concurs, noting that speed matters only for a small set of critical tests. “For conditions like dengue, for instance, a rapidly falling platelet count can mean a patient needs immediate hospitalization, making a two- or three-hour turnaround extremely important. But out of the roughly 4,500 types of tests we conduct, fewer than 20 genuinely require results within four hours. For most tests, whether the report arrives in two hours or eight hours does not materially change the medical outcome,” she told Mint.
Accuracy, or the lack of it, is another concern for medical professionals. “In molecular and microbiology workflows, accelerated timelines without adequate incubation or amplification cycles can risk under-detection. So, speed must always be contextual, not uniform across test categories,” explains Dr Charusheela Gote, Professor and Head of Department, Department of Pathology at DPU Super Specialty Hospital, Pimpri, Pune. “Certain tests are particularly vulnerable to time-pressure effects. Coagulation studies, blood gases, hormonal assays and some hematological parameters are highly sensitive to delays and handling variability.”
Metropolis’s Shah flags another larger concern: While all major labs and Orange Health are accredited with the National Accreditation Board for Testing and Calibration Laboratories (NABL), this is not true across the board. Of the nearly 300,000 labs in the country, says Shah, only a small fraction are NABL accredited, making it difficult for consumers to judge quality and reliability. In India, diagnostics remains a largely under-regulated sector where there are very few minimum operating standards, she noted. “Anyone can technically start a lab, but for patients the most important thing is not speed, it is accuracy. A report delivered fast is meaningless if it is wrong.”
Pharmeasy and Dr Lal PathLabs did not respond to Mint’s request for comments.
Economics and scale
The real challenge for Orange Health is scale. Industry executives say the biggest constraint in rapid diagnostics is density. Fast home collection only works when there is enough demand concentrated within a tight catchment area. In a sprawling city without sufficient density, it becomes difficult to promise 30-minute or one-hour collections because phlebotomists cannot be stationed every few kilometres like quick-commerce delivery workers. That is why experts believe the model is likely to work well only in dense urban markets.
“Move into lower-density cities or suburban markets and travel time rises, cost per collection rises, sample aggregation slows, and maintaining rapid turnaround times becomes expensive. At that point, the economics start resembling a logistics-heavy delivery business rather than a high-margin diagnostics platform,” says India Accelerator’s Bhatia.
Tata 1mg co-founder Gaurav Agarwal had a more nuanced view. “Delivering 60-minute collection implies excess collection capacity, disciplined logistics, dense geographic coverage, and the ability to maintain clinical standards while compressing timelines,” Agarwal told Mint. “Can it be done? Certainly. Can it scale beyond dense metros? Probably, though city economics will vary significantly. The more important question is whether it can be done consistently, with the right quality standards, and sustainably. Healthcare businesses ultimately need repeatable operating models.”
Gupta claims that Orange’s newer cities are now following a trajectory similar to Bengaluru. But beyond the top 15-20 cities, he acknowledges the company may need to adapt its operating model rather than simply replicating the Bengaluru playbook.
The big questions
The larger question is whether the incumbents can be as lithe as Orange Health claims to be. Gupta argues that the challenge is not a lack of capital or resources, but the difficulty of rewriting an existing business model.
The incumbents have major advantages such as established lab infrastructure, nationwide logistics, and doctor relationships, so they can launch home collection, and faster timelines, says Bhatia, adding that the harder part is operational and cultural.
“High-speed hyperlocal diagnostics requires real-time routing, tightly optimized phlebotomist operations, consumer-grade UX, rapid issue resolution, and very high service consistency,” Bhatia adds. “Large incumbents are typically optimized for scale, utilization, and physician-led workflows, not for an on-demand consumer experience.”
Bhambra believes the opportunity is far larger than what existing players have built so far. Citing internal estimates, he suggests that the market in India’s top urban centres alone could support businesses several times the size of Dr Lal PathLabs.
Metropolis’s Shah noted that there are two parallel worlds within diagnostics today: clinical diagnostics, where accuracy is everything because reports directly shape treatment decisions, and the growing wellness market, where consumers often prioritise speed, pricing and convenience.
Indeed, rising awareness around preventive healthcare and the growing popularity of specialized testing packages are emerging as key growth drivers for the diagnostics sector. According to a CareEdge Ratings report, wellness and preventive services contributed nearly 12-25% of total revenue for select diagnostic companies in FY25, up from 6-12% in FY21.
For Orange Health, the real test will be whether it can scale its model for a bigger play and whether it can sustain itself if larger rivals take a leaf out of its playbook.