The mission of the Cholinesterase Reference Laboratory (CRL) at the U.S. Army Center for Health Promotion and Preventive Medicine is to ensure cholinesterase-testing standardization within the Department of Defense (DOD) Cholinesterase Monitoring Program. The Cholinesterase Monitoring Program ensures proper occupational health monitoring of personnel engaged in chemical agent stockpile and demilitarization operations. The CRL currently provides technical guidance and expertise to several DOD entities as well as non-DOD federal agencies. Quality assurance oversight, comparative analysis, proficiency testing and on-site compliance inspections are provided to ten satellite laboratories engaged in Red Blood Cell Cholinesterase testing. In addition to quality assurance operations the CRL supports the Defense Threat Reduction Agency and several DOD facilities and contractors, engaged in chemical agent defense research, with RBC-ChE analysis of their personnel.