This article describes the process of building and implementing a quality and technical management system (QTMS) at a RIA laboratory in southern Taiwan. This was done to fulfill the requirements of the ISO 15189 Medical Laboratory Accreditation program. During the process, we created new procedure manuals and documents through the use of Plan-Do-Check-Action (PDCA). The laboratory staffs should be familiar with all of the QTMS documents. The aims of our QTMS are to promote our medical service quality, to achieve a good cost-effectiveness outcome, and to provide the best patient care.