The efficiency evaluation of laboratories, as one of the most significant areas of healthcare, plays a key role in the quality of laboratory management. The classic data envelopment analysis (DEA) models have overlooked intermediate products, internal interactions and dealt with analyzing the network within the “Black Box” mode. This results in the loss of important information, and at times, a considerable modification occurs in efficiency results. This article evaluated the efficiency of some selected medical diagnostic laboratories in the city of Tehran according to the network data envelopment analysis (NDEA) approach. We considered a four-stage structure with additional inputs and undesirable outputs. We obtain the labs’ performance over a period of 6 months in 2022 by the NDEA window analysis process. To this aim, a four-stage structure model of three chief medical diagnostic laboratory processes as the pre-test, the test, and the post-test is designed. We considered sustainability criteria (economic, social, and environmental) to appraise the performance of laboratories, thus helping to improve the social, economic, and environmental problems of medical diagnostic laboratories. By using the Delphi viewpoint, the criteria for efficiency evaluation are achieved. The results showed that laboratory unit No. 22 maintained the highest average overall efficiency, since the high accuracy of this unit’s laboratory results had led to many physicians recommending this unit to their patients. We found that the only laboratory unit No. 20 had a decreasing trend, as it is located in an area that abounds with administrative and educational centers. At the beginning of the exam period, then the summer holidays, and finally the wave of end-of-summer trips, a decline occurs in efficiency over the period of six months.

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