diff --git a/app/lab-integration/lab-sync-pre-processor.service.js b/app/lab-integration/lab-sync-pre-processor.service.js
new file mode 100644
index 000000000..40588cc91
--- /dev/null
+++ b/app/lab-integration/lab-sync-pre-processor.service.js
@@ -0,0 +1,241 @@
+'use strict';
+var rp = require('../../request-config');
+var config = require('../../conf/config');
+var moment = require('moment');
+var db = require('../../etl-db');
+
+var definition = {
+  processLabSyncReqest: processLabSyncReqest,
+  getRestResource: getRestResource,
+  isBatchMode: isBatchMode,
+  getPersonAttributes: getPersonAttributes,
+  hasVisitStartedToday: hasVisitStartedToday,
+  getPatientVisits: getPatientVisits,
+  savePendingLabResults: savePendingLabResults,
+  getCachedPendingLabResults: getCachedPendingLabResults,
+  processPendingLabResultRequest: processPendingLabResultRequest,
+  hasPendingVLOrder: hasPendingVLOrder
+};
+
+module.exports = definition;
+
+function processLabSyncReqest(params) {
+  const hasVisitStartedEnabled =
+    config.eid.filterOptions.hasVisitStartedEnabled;
+  return new Promise(function (resolve, reject) {
+    determineIfTestPatient(params.patientUuId)
+      .then((result) => {
+        if (result === false) {
+          const isBatch = isBatchMode(params);
+          if (isBatch === true) {
+            resolve(true);
+          } else {
+            if (hasVisitStartedEnabled) {
+              hasVisitStartedToday(params.patientUuId)
+                .then((result) => {
+                  if (result === true) {
+                    resolve(true);
+                  } else {
+                    resolve(false);
+                  }
+                })
+                .catch((error) => {
+                  reject(error);
+                });
+            } else {
+              resolve(true);
+            }
+          }
+        } else {
+          reject('ERROR: is a TestPatient');
+        }
+      })
+      .catch((error) => {
+        reject('ERROR: isTestPatient', error);
+      });
+  });
+}
+
+function getRestResource(path) {
+  var link = config.openmrs.host + ':' + config.openmrs.port + path;
+  if (config.openmrs.https === true) {
+    link = 'https://' + link;
+  } else {
+    link = 'http://' + link;
+  }
+  return link;
+}
+
+function isBatchMode(params) {
+  if (params.mode) {
+    const mode = params.mode;
+    if (mode === 'batch') {
+      return true;
+    }
+  } else {
+    return false;
+  }
+}
+
+function getPersonAttributes(patientUuid) {
+  var uri = getRestResource(
+    '/' + config.openmrs.applicationName + '/ws/rest/v1/person/' + patientUuid
+  );
+  var queryString = {
+    v: 'custom:(attributes:(uuid,display,value,attributeType:(uuid,display))'
+  };
+  return new Promise(function (resolve, reject) {
+    rp.getRequestPromise(queryString, uri)
+      .then(function (response) {
+        resolve(response.attributes);
+      })
+      .catch(function (error) {
+        reject(error);
+      });
+  });
+}
+
+function hasVisitStartedToday(patientUuId) {
+  return new Promise(function (resolve, reject) {
+    getPatientVisits(patientUuId)
+      .then((visits) => {
+        var hastodaysVisits = visits.some((visit) => {
+          return (
+            moment(visit.startDatetime).format('YYYY-MM-DD') ===
+            moment().format('YYYY-MM-DD')
+          );
+        });
+        resolve(hastodaysVisits);
+      })
+      .catch((error) => {
+        reject(error);
+      });
+  });
+}
+
+function getPatientVisits(patientUuid) {
+  var uri = getRestResource(
+    '/' + config.openmrs.applicationName + '/ws/rest/v1/visit'
+  );
+  var queryString = {
+    v: 'custom:(uuid,startDatetime,stopDatetime)',
+    patient: patientUuid
+  };
+  return new Promise(function (resolve, reject) {
+    rp.getRequestPromise(queryString, uri)
+      .then(function (response) {
+        resolve(response.results);
+      })
+      .catch(function (error) {
+        reject(error);
+      });
+  });
+}
+
+function savePendingLabResults(eidResults, personUuid) {
+  return new Promise((resolve, reject) => {
+    let queryParts = {};
+    let sql = '';
+
+    sql =
+      "replace into etl.eid_pending_results (person_uuid,pending_result) values ('" +
+      personUuid +
+      "','" +
+      eidResults +
+      "');";
+    queryParts = {
+      sql: sql
+    };
+    db.queryServer(queryParts, function (result) {
+      result.sql = sql;
+      resolve(result);
+    });
+  });
+}
+
+function getCachedPendingLabResults(personUuid) {
+  return new Promise((resolve, reject) => {
+    let queryParts = {};
+    let sql = '';
+
+    sql =
+      "select * from etl.eid_pending_results where person_uuid = '" +
+      personUuid +
+      "' AND DATE(date_created) = DATE(CURDATE()) order by date_created limit 1;";
+    queryParts = {
+      sql: sql
+    };
+    db.queryServer(queryParts, function (result) {
+      result.sql = sql;
+      resolve(result);
+    });
+  });
+}
+
+function processPendingLabResultRequest(patientUuid) {
+  return new Promise((resolve, reject) => {
+    determineIfTestPatient(patientUuid)
+      .then((result) => {
+        if (result === false) {
+          getCachedPendingLabResults(patientUuid)
+            .then((cachedResults) => {
+              let cachedEidResult = [];
+              if (cachedResults.size > 0) {
+                cachedEidResult = JSON.parse(
+                  cachedResults.result[0].pending_result
+                );
+                resolve(cachedEidResult);
+              } else {
+                resolve(cachedEidResult);
+              }
+            })
+            .catch((error) => {
+              reject(error);
+            });
+        } else {
+          reject('Is Test Patient');
+        }
+      })
+      .catch((error) => {
+        reject(error);
+      });
+  });
+}
+
+function hasPendingVLOrder(personUuid) {
+  return new Promise((resolve, reject) => {
+    let queryParts = {};
+    let sql = '';
+
+    sql =
+      "SELECT t3.uuid FROM amrs.orders t1 INNER JOIN amrs.person t3 ON t3.person_id = t1.patient_id LEFT OUTER JOIN amrs.obs t2 ON t1.order_id = t2.order_id where t2.order_id IS NULL AND t1.date_activated >= DATE('2020-01-01') AND t3.uuid = '" +
+      personUuid +
+      "';";
+    queryParts = {
+      sql: sql
+    };
+    db.queryServer(queryParts, function (result) {
+      result.sql = sql;
+      resolve(result);
+    });
+  });
+}
+
+function determineIfTestPatient(personUuid) {
+  var testPatientAttributeTypeUuid = '1e38f1ca-4257-4a03-ad5d-f4d972074e69';
+  return new Promise((resolve, reject) => {
+    getPersonAttributes(personUuid)
+      .then((result) => {
+        const isTestPatient = result.some((attribute) => {
+          return (
+            attribute.attributeType.uuid === testPatientAttributeTypeUuid &&
+            attribute.value === true
+          );
+        });
+        resolve(isTestPatient);
+      })
+      .catch((error) => {
+        reject(error);
+      });
+  });
+}
diff --git a/app/lab-integration/lab-sync-service.js b/app/lab-integration/lab-sync-service.js
index c7078e280..9b59008c5 100644
--- a/app/lab-integration/lab-sync-service.js
+++ b/app/lab-integration/lab-sync-service.js
@@ -12,25 +12,39 @@ import { VLAdapter } from './adapters/vl-adapter';
 import { DNAPCRAdapter } from './adapters/dnapcr-adpater';
 import { CD4Adapter } from './adapters/cd4-adapter';
 import { EidCompareOperator } from './utils/eid-compare-operator';
+import { PatientLastOrderLocationService } from '../../service/eid/eid-patient-last-order-location.service';
 
 export class LabSyncService {
   syncAllLabsByPatientUuid(patientUuid, reply) {
     let tasks = [];
-    Object.keys(config.hivLabSystem).forEach((labLocation) => {
-      tasks.push((cb) => {
-        // delay alupe for a few ms
-        cb(
-          null,
-          this.syncLabsByPatientUuid(
-            patientUuid,
-            labLocation,
-            labLocation === 'alupe' ? 50 : 0
-          ).then((result) => {
-            return result;
-          })
-        );
+    const service = new PatientLastOrderLocationService();
+    service
+      .isPatientLastOrderLocationAffliatedToAlupe(patientUuid)
+      .then((isAffliated) => {
+        Object.keys(config.hivLabSystem).forEach((labLocation) => {
+          tasks.push((cb) => {
+            // delay alupe for a few ms
+            cb(
+              null,
+              this.syncLabsByPatientUuid(
+                patientUuid,
+                labLocation,
+                labLocation === 'alupe' ? 50 : 0
+              )
+                .then((result) => {
+                  return result;
+                })
+                .catch((error) => {
+                  return error;
+                })
+            );
+          });
+        });
+        this.syncLabsParallel(tasks, reply);
       });
-    });
+  }
+
+  syncLabsParallel(tasks, reply) {
     async.parallel(async.reflectAll(tasks), (err, results) => {
       // currently we have duplicate data in db. Try to remove here
       Promise.all(results.map((result) => result.value))
@@ -44,7 +58,6 @@ export class LabSyncService {
           reply(_lab_data);
         })
         .catch((err) => {
-          console.log('sync service error', err);
           reply(Boom.notFound('Sorry, sync service temporarily unavailable.'));
         });
     });
@@ -73,7 +86,7 @@ export class LabSyncService {
                 };
               })
               .catch((error) => {
-                console.log('ERROR', error);
+                return Promise.reject(error);
               });
           } else {
             return this.syncAndGetPatientLabResults(patientUuid, labLocation)
@@ -81,7 +94,7 @@ export class LabSyncService {
                 return this.syncLabsByPatientUuid(patientUuid, labLocation);
               })
               .catch((err) => {
-                console.log('ERROR Getting results', err);
+                return Promise.reject(err);
               });
           }
         } else {
@@ -90,12 +103,13 @@ export class LabSyncService {
               return this.syncLabsByPatientUuid(patientUuid, labLocation);
             })
             .catch((error) => {
-              console.log('ERROR', error);
+              return Promise.reject(error);
             });
         }
       })
       .catch((error) => {
         console.error('getLabSyncLog error', error);
+        return Promise.reject(error);
       });
   }
 
@@ -240,19 +254,30 @@ export class LabSyncService {
                     return eidService
                       .saveEidSyncLog(table, fields, savedObs)
                       .catch((error) => {
-                        console.log('ERROR saving logs', error);
+                        return Promise.reject(error);
                       });
                   })
                   .catch((error) => {
-                    console.error('ERROR : combineObsPostPromises', error);
+                    return new Promise((resolve, reject) => {
+                      fields[0].status = 1;
+                      fields[0].message = error.toString();
+                      eidService
+                        .saveEidSyncLog(table, fields, [])
+                        .then((result) => {
+                          reject(error);
+                        })
+                        .catch((error) => {
+                          reject(error);
+                        });
+                    });
                   });
               })
               .catch((error) => {
-                console.error('ERROR : labResultsPromises', error);
+                return Promise.reject(error);
               });
           })
           .catch((error) => {
-            console.error('ERROR : Fetching results', error);
+            return Promise.reject(error);
           });
       });
   }
diff --git a/dao/eid/eid-patient-last-order-location.js b/dao/eid/eid-patient-last-order-location.js
new file mode 100644
index 000000000..37658324e
--- /dev/null
+++ b/dao/eid/eid-patient-last-order-location.js
@@ -0,0 +1,28 @@
+import QueryService from '../../app/database-access/query.service';
+
+export class PatientLastOrderLocationDao {
+  constructor() {}
+
+  getPatientLastOrderLocation(patientUuid) {
+    let queryRunner = new QueryService();
+
+    let sqlQuery =
+      `SELECT e.location_id as location FROM amrs.encounter e
+        LEFT JOIN amrs.orders o on o.encounter_id = e.encounter_id
+        INNER JOIN amrs.person p on o.patient_id = p.person_id
+        WHERE p.uuid = '` +
+      patientUuid +
+      `' ORDER BY e.encounter_datetime DESC LIMIT 1;`;
+
+    return new Promise((resolve, reject) => {
+      queryRunner
+        .executeQuery(sqlQuery)
+        .then((results) => {
+          resolve(results);
+        })
+        .catch((error) => {
+          reject(error);
+        });
+    });
+  }
+}
diff --git a/etl-routes.js b/etl-routes.js
index 54e6ee606..eacdb4dea 100755
--- a/etl-routes.js
+++ b/etl-routes.js
@@ -74,6 +74,7 @@ import { PrepReminderService } from './service/prep-reminder/prep-reminder.servi
 import { HIVGainsAndLossesService } from './service/gains-and-losses/hiv-gains-losses-service';
 const cervicalCancerScreeningService = require('./service/cervical-cancer-screening-service');
 import { MOH412Service } from './service/moh-412/moh-412';
+const syncPreproc = require('./app/lab-integration/lab-sync-pre-processor.service');
 import { DefaulterListService } from './service/defaulter-list-service';
 import { ClinicFlowService } from './service/clinic-flow-service';
 
@@ -4003,10 +4004,22 @@ module.exports = (function () {
         handler: function (request, reply) {
           if (config.eidSyncOn === true) {
             const labSyncService = new LabSyncService();
-            labSyncService.syncAllLabsByPatientUuid(
-              request.query.patientUuId,
-              reply
-            );
+            syncPreproc
+              .processLabSyncReqest(request.query)
+              .then((validRequest) => {
+                if (validRequest) {
+                  labSyncService.syncAllLabsByPatientUuid(
+                    request.query.patientUuId,
+                    reply
+                  );
+                } else {
+                  reply(validRequest);
+                }
+              })
+              .catch((error) => {
+                console.error('ERROR: ', error);
+                reply(error);
+              });
           } else {
             reply(
               Boom.notImplemented(
diff --git a/service/eid/eid-patient-last-order-location.service.js b/service/eid/eid-patient-last-order-location.service.js
new file mode 100644
index 000000000..042addc0c
--- /dev/null
+++ b/service/eid/eid-patient-last-order-location.service.js
@@ -0,0 +1,48 @@
+import { PatientLastOrderLocationDao } from '../../dao/eid/eid-patient-last-order-location';
+
+const config = require('../../conf/config');
+
+export class PatientLastOrderLocationService {
+  constructor() {}
+
+  getPatientLastOrderLocation(patientUuid) {
+    const dao = this.getDao();
+
+    return new Promise((resolve, reject) => {
+      return dao
+        .getPatientLastOrderLocation(patientUuid)
+        .then((results) => resolve(results))
+        .catch((error) => reject(error));
+    });
+  }
+
+  isPatientLastOrderLocationAffliatedToAlupe(patientUuid) {
+    //Busia, Busia MCH, port victoria, Bumala A, Bumala B, Osieko, Matayos, Mukhubola, Teso, Malaba,
+    //Kamolo, Angurai, Changara, Mt. Elgon, Cheptais
+    const alupeLabLocations = config.eid.alupe.facilityIds;
+
+    return new Promise((resolve, reject) => {
+      this.getPatientLastOrderLocation(patientUuid)
+        .then((results) => {
+          if (results.length > 0) {
+            const lastOrderLocation = results[0].location;
+            if (lastOrderLocation) {
+              resolve(alupeLabLocations.includes(lastOrderLocation));
+            } else {
+              //If lastOrderLocation === undefined or 0 should resolve true
+              resolve(true);
+            }
+          } else {
+            resolve(true);
+          }
+        })
+        .catch((error) => {
+          reject(error);
+        });
+    });
+  }
+
+  getDao() {
+    return new PatientLastOrderLocationDao();
+  }
+}