At Harrisburg Hospital of the Pinnacle Health System, clinical laboratory facilities needed to be consolidated into an appropriately located facility from somewhat disperse locations on the existing campus.  The chosen site was a surface parking area adjacent to the hospital which also served as the ambulance access to the Emergency Department.  The site was the last available on this city block.  Challenges included maintaining ambulance access during construction, and when complete, preserving parking and ambulance access to the Emergency Department and providing a building to fulfill current needs but designed for future expansion.  The solution is a four-story structural steel framed, laboratory and medical office building containing 62,000 square feet of space raised above street level with open parking, traffic flow, and emergency department access at grade below the building.  To preserve the highest use of the site the structure is design for four additional floors to be added in the future.