Context.-Harmonization and standardization of results among different clinical laboratories is necessary for clinical practice guidelines to be established. Objective.-To evaluate the state of the art in measuring 10 routine chemistry analytes. Design.-A specimen prepared as off-the-clot pooled sera and 4 conventionally prepared specimens were sent to participants in the College of American Pathologists Chemistry Survey. Analyte concentrations were assigned by reference measurement procedures. Participants.-Approximately 6000 clinical laboratories. Results.-For glucose, iron, potassium, and uric acid, more than 87.5% of peer groups meet the desirable bias goals based on biologic variability criteria. The remaining 6 analytes had less than 5...