The New Hampshire Public Health Laboratories (NH PHL) conducted an initial Laboratory System Improvement Program (L-SIP) assessment in March 2007 and a reassessment in May 2011. New Hampshire was a pilot state for the initial L-SIP assessment in 2007 and was the first laboratory system in the United States to conduct an L-SIP reassessment. The New Hampshire reassessment was also used as a pilot for revising the assessment tool. The NH PHL performed a high-level comparison benchmarking the work done between the two assessments. This comparison revealed areas of improvement and other areas that needed continued focus to align with model standards of the 10 Essential Public Health Services. This article outlines achievements, improvements, and outcomes made since 2007, as well as participants, activities, plans, resources, and other factors that contributed to the change in scores between assessments.