The rapid scale-up of HIV care and treatment in resource-limited settings has overwhelmed many public health laboratory services already burdened with human resource shortages, an aging and inadequate infrastructure, and a lack of quality systems. There is, however, a growing appreciation of the opportunity to use HIV-related laboratory strengthening as means to strengthen health systems in general. We briefly describe ongoing efforts to integrate HIV laboratory support into HIV care and treatment systems, thereby strengthening laboratory systems in support of both HIV scale-up and overall health systems strengthening.