The nation is on the cusp of historic and civilization-advancing change with the upcoming health care reform bill, and that change bodes well for Quest Diagnostics (NYSE: DGX), which is why I'm reiterating my Buy rating for the company, first recommended on June 25, 2009, at a price of $55.89.

Quest's positive story remains the same: diagnostic tests are at the core of health care services, and even though the number of tests per citizen will likely decline in the years ahead, when one adds 30-45 million more citizens regularly accessing health care services annually, within 10 years, the probability of increased business is high, to say the least.

The earnings crunch begins in earnest this week, and analysts surveyed by Thomson Reuters are expecting a parade of companies reporting profit declines in the just completed quarter. That includes more financials, such as American Express Co. (NYSE: AXP), Bank of New York Mellon Corp. (NYSE: BK), M&T Bank Corp. (NYSE: MTB), Northern Trust Corp. (NASDAQ: NTRS), State Street Corp. (NYSE: STT), US Bancorp (NYSE: USB), and Wells Fargo & Co. (NYSE: WFC). On the other hand, Capital One Financial Corp. (NYSE: COF), E*Trade Financial Corp. (NASDAQ: ETFC), Regions Financial Corp. (NYSE: RF), and Zions Bancorp. (NASDAQ: ZION) are expected to post losses.

This week's anticipated earnings decliners also include tech companies such as Apple Inc. (NASDAQ: AAPL), Lexmark International Inc. (NYSE: LXK), Microsoft Corp. (NASDAQ: MSFT), Qualcomm Inc. (NASDAQ: QCOM), Texas Instruments Inc. (NYSE: TXN), and Yahoo! Inc. (NASDAQ: YHOO). Advanced Micro Devices Inc. (NYSE: AMD) is expected to post a loss.

It goes without saying that I favor health care and health care support services, and with the aforementioned in mind Quest Diagnostics (NYSE: DGX) is worth a review.

In general, analysts see a 3-5% revenue increase for Quest in FY2009, on an increase in esoteric testing and stronger tests per requisition.

Analyst upgrades:

• Merriman upgraded Dendreon (NASDAQ: DNDN) to Buy from Neutral on expectations shares will react positively to the full IMPACT data release on April 28. The firm thinks Provenge could represent the first cancer immunotherapy approved in the U.S. and raised its valuation range on the stock to $33-$34 from $18-$19.
• Piper Jaffray upgraded Andersons (NASDAQ: ANDE) as it believes the valuation is attractive, investor expectations are low, and the company's fertilizer and rail segments could recovery in FY10. The firm has a $19 target on shares. Goldman upgraded the auto sector to Neutral from Cautious and added Ford (NYSE: F) to its Conviction Buy list. The analyst does not believe Ford will have to declare bankruptcy and sees the company benefiting from Chrysler share declines and GM's (NYSE: GM) reduced product offerings. Ford's price target is $6
• Banc of America/Merrill upgraded U.S. Airways (NYSE: LCC) to Buy from Underperform.
• Broadcom (NASDAQ: BRCM) was upgraded to Equal Weight from Underweight at Morgan Stanley.
• Caterpillar (NYSE: CAT) was raised to Overweight from Neutral at JP Morgan.

Analyst upgrades:

• Merriman upgraded Taser (NASDAQ: TASR) to Buy from Neutral as it believes current valuation levels do not reflect the company's market opportunities and that the law enforcement funding in President Obama's stimulus plan will boost sales in Q4 and FY10.
  
• Goldman upgraded Macy's (NYSE: M) to Buy from Neutral and added shares to its Conviction Buy List based on reduced balance sheet concerns and improved risk/reward. The firm also raised their target to $8.25 from $8.
  
• JP Morgan upgraded Family Dollar (NYSE: FDO) to Neutral from Underweight and raised its target to $29 from $19 following the better-than-expected Q2 report. The analyst continues to prefer Dollar Tree (NASDAQ: DLTR) and Wal-Mart (NYSE: WMT).
• Goldman removed Universal Am (NYSE: UAM) from the Conviction Sell List.
  
• McDermott (NYSE: MDR) was upgraded to Buy from Hold at Jefferies.
  
• Canadian Natural (NYSE: CNQ) was upgraded to Sector Outperformer from Sector Performer at CIBC.

Analyst upgrades:

• Baird upgraded MSM Industrial (NYSE: MSM) to Outperform from Neutral based on valuation and a positive view for Industrial Distributors.
  
• William Blair upgraded Allscripts (NASDAQ: MDRX) to Outperform from Market Perform on valuation following the recent pullback and believes Allscripts is well positioned to benefit from public policy that drives adoption of electronic medical records.
  
• Citigroup upgraded Consolidated Edison (NYSE: ED) to Buy from Hold as they believe the ALJ recommendation in the company's pending electric rate case indicates potential for an improving outlook.
• Raytheon (NYSE: RTN) was raised to Buy from Neutral at Goldman.
  
• Smith & Nephew (NYSE: SNN) was upgraded at JP Morgan to Neutral from Underweight.
  
• Becton Dickinson (NYSE: BDX) was upgraded to Overweight from Equal Weight at Morgan Stanley.

Analyst downgrades:

• Oppenheimer downgraded Bio-Reference Labs (NASDAQ: BRLI) to Perform from Outperform as they believe weaker volumes could pressure top-line growth in the near-term. The firm lowered their target to $25 from $30.
  
• Morgan Stanley downgraded shares of Alcatel-Lucent (NYSE: ALU) to Equal Weight from Overweight to reflect market deterioration as they find the risk/reward as balanced at current levels.
  
• JP Morgan cut Nestle (OTC: NSRGY) to Underweight from Neutral on concerns the company's 2009 revenue will miss consensus estimates due to market share losses.
• Rio Tinto (NYSE: RTP) and Anglo American (NASDAQ: AAUK) were lowered to Hold from Buy at Deutsche Bank.

Analyst upgrades:

• Baird upgraded Optimer Pharm (NASDAQ: OPTR) to Outperform from Neutral and raised its target to $13 from $8 citing the decidedly positive data from the OPT-80 trial.
  
• Banc of America upgraded Quest Diagnostics (NYSE: DGX) to Buy from Neutral on valuation and believes management has set expectations well.
  
• Credit Suisse views Jacobs Engineering (NYSE: JEC) as a high quality name given the quality of management, execution track record, and relationship business model. Shares were upgraded to Outperform from Neutral.
• Horizon Lines (NYSE: HRZ) was upgraded to Overweight from Equal Weight at Stephens.
  
• Bancolombia SA (NYSE: CIB) was raised to Buy from Neutral.
  
• Great Lakes Dredge (NASDAQ: GLDD) was upgraded to Buy from Hold at Morgan Joseph.

Analyst downgrades:

Analyst upgrades:

• William Blair raised Quest Diagnostics (NYSE: DGX) to Outperform from Market Perform. The firm believes that the long-term fundamentals of the clinical laboratories sectors are still strong.
  
• UBS upgraded Massey Energy (NYSE: MEE) to Buy from Neutral on valuation.
  
• ArthroCare (NASDAQ: ARTC) was upgraded to Buy from Hold by Lazard, since the firm expects a small restatement while they believe a large restatement is priced into the shares.
• Arch Coal (NYSE: ACI) was upgraded to Buy from Neutral by UBS.
• Merrill Lynch raised Southern Peru Copper (NYSE: PCU) to Neutral from Underperform.

Analyst downgrades:

• Piper downgraded Salesforce.com (NYSE: CRM) to Neutral from Buy to reflect the company's lower than expected deferred Q2 revenue.
• Goldman Sachs removed Amylin Pharmaceutical (NASDAQ: AMLN) from its Conviction Buy List.
  

Analyst initiations:

• Aetna (NYSE: AET) was initiated with a Buy by Banc of America, which believes the company will experience industry-leading member growth.
  
• Banc of America initiated Wellpoint (NYSE: WLP) with a Buy rating, as the firm expects the shares to rebound from near trough valuations.
  
• Wachovia (NYSE: WB) was reinitiated by Friedman Billings with an Underperform rating, as the firm expects the company to incur higher credit losses than the Street expects due to its outsized exposure to residential real estate.
  
• Six Flags (NYSE: SIX) was started with an Above Average rating by Caris.

MOST NOTEWORTHY: Pfizer, Dell, Quest Diagnostics, and Societe Generale were today's noteworthy upgrades:

• Lehman upgraded Pfizer (NYSE: PFE) to Equal Weight from Underweight on valuation.
  
• Friedman Billings raised Dell (NASDAQ: DELL) to Outperform from Market Perform, citing expectations for improved margins next quarter, and valuation.
  
• Quest Diagnostics (NYSE: DGX) was upgraded to Outperform from Neutral by Credit Suisse, which cited valuation.
  
• Lehman upgraded shares of Societe Generale (OTC: SCGLY) to Overweight from Underweight to reflect a potential takeover by BNP Paribas and limited downside.

OTHER UPGRADES:

• Bayer (OTC: BAYRY) was raised to Overweight from Equal Weight by Lehman.
• Deutsche Telekom (NYSE: DT) was upgraded to Hold from Sell by Citigroup.
• Public Storage (NYSE: PSA) was raised to Buy from Hold by Deutsche Bank.
• UBS raised Entergy (NYSE: ETR) to Buy from Neutral.

MOST NOTEWORTHY: AeroVironment, American Oriental and Intel were today's noteworthy initiations:

• Suntrust initiated AeroVironment (NASDAQ: AVAV) with a Buy rating and $32 target and expects AVAV's market leadership in unmanned aerial systems and increased effort in the high altitude to drive strong organic growth.
• Jefferies believes American Oriental (NYSE: AOB) is capable of making sizable acquisitions given its strong cash position and finds the valuation attractive at current levels. The firm started shares with a Buy rating and $20 target.
• Intel (NASDAQ: INTC) was initiated with a Neutral rating and $30 target at Baird on valuation.

OTHER INITIATIONS:

• Equinix (NASDAQ: EQIX) was initiated with a Market Perform rating at Wachovia.
• Goldman started Quest Diagnostics (NASDAQ: DGX) with a Sell rating and $55 target, LabCorp (NASDAQ: LH) with a Neutral rating and $77 target and Pinnacle Entertainment (NASDAQ: PNK) with a Buy rating and $35 target.

MOST NOTEWORTHY: Gen-Probe, Monster Worldwide, LabCorp and Quest Diagnostics were today's noteworthy initiations:

• Deutsche Bank initiated shares of Gen-Probe (NASDAQ: GPRO) with a Buy rating and $78 target and expects the company's broad product portfolio in Clinical Diagnostics and Blood Screening to drive growth.
  
• CIBC initiated Monster Worldwide (NASDAQ: MNST) with a Sector Performer rating, as they believe their macro concerns are more important than the company's intermediate-term prospects and its position within the global recruiting market.
  
• William Blair views the valuation of LabCorp (NYSE: LH) as compelling given the company's growth outlook. The firm started shares off with an Outperform rating.
  
• William Blair also initiated Quest Diagnostics (NYSE: DGX) with a Market Perform rating, and prefers a wait-and-see approach as the company's diversification strategy unfolds.

OTHER INITIATIONS:

• Wachovia initiated Cleco (NYSE: CNL), ITC Holdings (NYSE: ITC) and Aqua America (NYSE: WTR) with Outperform ratings and American States Water (NYSE: AWR) with a Market Perform rating.
  
• Baird resumed coverage of Ritchie Bros (NYSE: RBA) with a Neutral rating and $78 target.

MOST NOTEWORTHY: BEA Systems, Nokia, Medco Health, Quest Diagnostics and PetSmart were today's noteworthy downgrades:

• Citigroup downgraded shares of BEA Systems (NASDAQ: BEAS) to Hold from Buy on valuation following the $17/share offer by Oracle (NASDAQ: ORCL) as they think a public bidding war for the company is unlikely.
  
• ABN Amro downgraded shares of Nokia Corporation (NYSE: NOK) to Hold from Buy on valuation and believes above consensus Q3 results are already priced into shares.
  
• Wachovia downgraded Medco Health Solutions (NYSE: MHS) to Market Perform from Outperform on valuation.
  
• The firm also downgraded Quest Diagnostics (NYSE: DGX) to Market Perform from Outperform, as they believe the prospects from stabilizing volumes and cost savings are reflected in valuation and Street estimates.
  
• Credit Suisse downgraded shares of PetSmart (NASDAQ: PETM) to Neutral from Outperform citing aggressive pricing at Petco, accelerating growth initiatives, limited visibility around expense management, and lack of consistent results.

OTHER DOWNGRADES:

• Methanex Corporation (NASDAQ: MEOH) was downgraded to Sector Underperformer from Sector Performer at CIBC.
  
• Rochdale downgraded Heico Corporation (NYSE: HEI) to Neutral from Buy.
  
• JP Morgan downgraded BankUnited Financial Corp (NASDAQ: BKUNA) to Neutral from Outperform and removed Qwest Communications (NYSE: Q) from its Focus List.
  
• Goldman removed MetLife (NYSE: MET) from its Conviction Buy List.
  
• Coldwater Creek (NASDAQ: CWTR) was downgraded to Hold from Buy at Standford and at Stifel.

Is it time to jump back into Quest Diagnostics (NYSE: DGX)?

Quest Diagnostics, which provides laboratory services to roughly 50% of the nation's doctors and hospitals, fell out of favor after it lost a large client, amid building price pressure.

Slowing growth, and an above-average sector valuation also were data points offered by those making the bearish case.

The bullish case, on the other hand, argues that Quest's recent cost cutting initiatives, strong cash flow, and growing demand for sophisticated medical tests (bolstered by that old standby, the aging Baby Boomer generation) suggest solid long-term growth prospects for DGX. Quest is trading around $55 with a P/E of 19.

(Note: Technical analysis agnostics stop reading here. All others, continue.)

From a technical analysis standpoint, Quest's chart appears to have formed a double-bottom around $47.90 in March/April and May/June.

Investment Category: Quest is a moderate-risk stock not suitable for low-risk investors. The Reuters 2007 and 2008 earnings per share consensus estimates for DGX are $2.87 and $3.25, respectively.

MOST NOTEWORTHY: Old Dominion Freight (ODFL), Jamba (JMBA), AMD (AMD), Orbitz Worldwide (OWW) and Quest Diagnostics (DGX) were today's notable initiations:

• Baird is positive on Old Dominion's (NASDAQ: ODFL) growth opportunities, valuation, 2008 improving truck fundamentals, and a potentially seasonally stronger Q4, starting shares with an Overweight rating and $36 target.

• Merriman initiated Jamba (NASDAQ: JMBA) with a Buy rating, as the company aggressively expands its store base beyond California.

• BMO Capital believes AMD (NYSE: AMD) may lose the Intel platform integrated graphics market, and sizeable Intel platform discrete graphics market share. The firm initiated AMD shares with an Underperform rating and $10 target.

• Soleil has concerns regarding Orbitz Worldwide's (NYSE: OWW) decelerating growth and poorer business mix vs. competitors and started shares with a Hold rating and $13 target.

• Credit Suisse initiated Quest Diagnostics (NYSE: DGX) with a Neutral rating and $61 target, citing the recent UnitedHealth (UNH) contract loss, slowing growth, and valuation for its Neutral rating...

OTHER INITIATIONS:

• McDermott (NYSE: MDR) and Capella Education (NASDAQ: CPLA) were initiated with Buy ratings at Citigroup.

• JMP Securities started ShoreTel (NASDAQ: SHOR) with a Market Outperform rating.

• Credit Suisse initiated LabCorp (NYSE: LH) with an Outperform rating.

• FTN Midwest started Northwest Airlines (NYSE: NWA) with a Buy rating.

Analyst summaries provided by TheFlyOnTheWall.com (subscription required).

Diagnostic medical tests guide physicians through the process of diagnosing diseases and measuring the progress of recovery. The leading U. S. provider of diagnostic testing services is a Lyndhurst, New Jersey outfit that performs personal health testing on more than 150 million patients a year. It was the first laboratory in the country to achieve ISO 9001 certification.

Quest Diagnostics (NYSE: DGX) provides diagnostic testing services to the healthcare industry. Offerings include routine blood tests, pap tests, urinalyses, pregnancy tests, asthma and allergy tests, gene-based tests and tests for drugs of abuse. It also provides anatomic pathology services, testing for clinical trials, and risk assessment services for the life insurance industry. Through its Nichols Institute Diagnostics subsidiary, the firm manufactures and markets diagnostic test kits and systems to hospitals, clinical laboratories and dialysis centers. Quest operates more than 2,000 sample collection centers, 30 primary labs and 150 rapid response labs throughout the US and in Mexico and the UK. The firm has testing contracts with such health insurers as Aetna (NYSE: AET) and Cigna (NYSE: CI).

The company surprised the Street earlier in the week, when it reported Q2 EPS of 73 cents and revenues of $1.64 billion. Analysts had been looking for 68 cents and $1.61 billion. Management also guided FY07 EPS to $2.80-2.95 ($2.80 consensus) and FY07 revenues to $6.6-6.7 billion ($6.61B consensus).