A Fayette-side occupational-medicine clinic on the I-75 / New Circle corridor selling DOT physicals, drug-screening panels, and employer occ-med contracts to Fayette-resident commuter households, not to TMMK.

Five revenue streams stack on the corridor position. DOT physicals under 49 CFR 391.43 are required every 24 months for any worker with a CDL or operating a commercial motor vehicle. Pre-employment, random-pool, post-incident, and reasonable-suspicion drug-screening panels run under 49 CFR Part 40 — 5-panel and 10-panel urine collection, breath-alcohol testing, hair-follicle where the employer requires it, and MRO review on positives. OSHA medical surveillance covers audiometry under 29 CFR 1910.95, pulmonary function testing and respirator medical clearance under 29 CFR 1910.134, and blood-lead and zinc-protoporphyrin where lead exposure is regulated. Workers'-compensation injury management and return-to-work coordination run under the Kentucky Department of Workers' Claims. Walk-in urgent-care occupational overflow serves UK HealthCare transport, Lexmark forklift operators, FedEx LEX, Amazon LEX1, FCPS bus operations, the LFUCG Public Works fleet, and dozens of mid-size Lexington commercial employers — all interchangeable against the same NRCME credential and OSHA protocols.

Fayette outbound-commute headcount to the Toyota geometry sits at a working range of 2,900 to 6,900 with a midpoint near 4,000 to 5,000, against LEHD OnTheMap commuter-flow tables for Fayette to Scott, Bourbon, Woodford, Harrison, and Franklin. CDL-holders inside that geometry at industry shares of 4 to 9 percent of total employment imply 200 to 450 Fayette CDL-holders requiring DOT physicals every 24 months — 100 to 225 Fayette recertifications a year from the Toyota commuter pool alone. FCPS bus operations runs 700 to 900 drivers; LFUCG Public Works, LexTran, FedEx Ground LEX, Amazon LEX1, UPS Lexington, and regional LTL carriers (Saia, Estes, Old Dominion) add construction-fleet CDL holders, agricultural haulers, and individual owner-operators based in Fayette.

Corridor positioning is the central operational choice. The clinic sits on the I-75 / New Circle corridor at a north-Lexington exit — Newtown Pike, North Broadway, Russell Cave / Bryan Station, or Winchester Road — so the southbound 2:30 pm shift commuter can exit, complete a DOT recertification or a follow-up workers'-comp visit, and be home in 10 to 15 minutes instead of driving 25 miles further into south Lexington. The same position serves morning pre-shift drug-screen collection for the northbound commuter and Saturday DOT-physical slots scheduled around mandatory-overtime weeks at TMMK and the Tier-1 plants.

Existing Lexington occupational-medicine incumbents include Concentra (a multi-state chain with at least one Lexington location), US HealthWorks (absorbed by Concentra in 2018 via Select Medical), Norton Healthcare Occupational Health, UK HealthCare Occupational Medicine (a potential referral partner depending on the employer-contract footprint), Baptist Health Lexington Occupational Health, CHI Saint Joseph Occupational Health, and several independent single-site Lexington urgent-care operators that handle some DOT-physical volume as a sideline. The operator does not characterize any incumbent's business practice, pricing, or care.

The location gap is real. Lexington's occupational-medicine supply concentrates downtown and along the south-Lexington corridors (Nicholasville Road and Man-o-War Boulevard) where the UK, Baptist, and CHI campuses anchor. The north-Lexington I-75 / New Circle corridor is under-supplied for an occ-med clinic positioned for the reverse-commute flow toward TMMK and the Tier-1 and Tier-2 plants. A dedicated NRCME-credentialed corridor clinic with morning-shift collection hours (5:30 to 7 am for pre-shift screens), late-afternoon hours (3 to 7 pm for post-shift physicals), and Saturday DOT-physical slots fits an unfilled schedule-and-location combination.

The candidate absorbs EV-transition risk. Occupational-medicine, DOT-physical, and drug-screen volume is interchangeable across employers — a 20 to 40 percent TMMK headcount reduction would shift demand toward UK HealthCare, Lexmark, FedEx LEX, Amazon LEX1, FCPS, and LFUCG fleet operations without erasing it. The candidate sits on the Lexington-resident side of the labor shed, not on the Scott-County-resident TMMK-direct vendor side.

Unit-revenue building blocks (to confirm against current Kentucky-market published rate cards): DOT physical $75-$150 per encounter, ~$110 working midpoint; 5-panel urine drug screen $30-$60 per collection, ~$45 working midpoint; 10-panel or hair-follicle $50-$100, ~$75 working midpoint; breath-alcohol test under DOT Part 40 $35-$65, ~$50 working midpoint; OSHA audiometry baseline + annual $30-$75, ~$50 working midpoint; PFT + respirator-clearance exam $75-$175, ~$120 working midpoint; W/C initial injury visit $150-$350, ~$240 working midpoint; W/C follow-up $100-$200, ~$150 working midpoint; recurring employer occ-med contract $5-$25 PEPM at small-employer scale; MRO review fee per confirmed positive $25-$75, ~$45 working midpoint.

Year-1 ramp illustrative scenario. DOT physicals 6/day × 5 days × 48 weeks = 1,440 × $110 = ~$158K. Drug-screen collections 8/day × 5 × 48 = 1,920 × $45 = ~$86K. Pre-employment + post-incident screens via 4-6 small Tier-2 + non-Toyota employer contracts = ~$60-90K. OSHA surveillance ramping Q3-Q4 = ~$30-60K. W/C visits ramping = ~$40-80K. Walk-in urgent-care occ-med overflow = ~$30-60K. Year-1 revenue working range $400-$540K.

Year 2-3 maturity scenario. DOT physicals 10-14/day → 2,400-3,400 annual → $260-375K. Drug-screen volume 12-18/day → 2,900-4,300 annual collections → $130-195K. OSHA surveillance under 15-25 employer contracts → $80-175K. W/C visits + RTW coordination across 8-15 W/C carriers → $120-250K. Recurring employer contracts at maturity → $80-180K recurring PEPM. Walk-in occ-med + urgent-care overflow → $80-150K. Maturity revenue working range $750K-$1.3M.

Operating-cost stack at maturity. NRCME-certified medical examiner (one full-time MD/DO/APRN/PA) total compensation $180-$260K depending on credential + retention market. Second-examiner partial-FTE or PA/NP coverage $90-$140K at 0.5-0.7 FTE for Saturday + after-hours. 2-3 MA + 1 front-desk + 1 billing/coding FTE $180-$280K. Clinic lease (1,800-2,800 sq ft corridor) $40-$80K annual. Equipment + consumables (vision tester, audiometer, spirometer, fit-test gear, urine-collection supplies, point-of-care kits, EMR subscription) $30-$60K annual once initial buildout amortizes. W/C billing + revenue-cycle-management $25-$60K. Insurance (medical-professional liability, general, cyber, business-interruption) $15-$35K. Marketing + corridor signage + employer-outreach sales $25-$50K. Total operating costs at maturity ~$650-$900K.

Founder draw progression (assumes owner-operator NRCME-certified examiner OR partner-examiner income-split). Year 1 ~$60-$110K against revenue ramp; clinic at break-even or modest cash-burn against $300-700K initial capital. Year 2 ~$95-$160K as physical-encounter volume scales and second employer contracts close. Year 3 maturity $130-$220K take-home consistent with industry founder-operator + NRCME-examiner combined compensation in mid-size Kentucky metros.

Founder-economics caveat. If the founder is not personally NRCME-credentialed and must retain a salaried NRCME-certified MD/DO examiner at $200K-$260K, the founder draw compresses by ~$60-110K relative to the owner-operator-examiner case. The strongest founder-fit is the NRCME-certified MD, DO, APRN, or PA who launches the practice themselves, not the non-clinical founder who tries to hire-and-manage clinical talent under thin margins.

Capital stack at launch ($300-$700K total). Corridor build-out (1,800-2,800 sq ft, ADA-compliant exam rooms × 3-4, chain-of-custody collection room, audiometric booth, point-of-care lab corner, breath-alcohol testing space, front-desk + waiting room) $120-$280K depending on shell condition + lease-improvement allowance. Equipment (audiometer, vision tester, spirometer, fit-test apparatus, urinary-collection supplies, point-of-care drug-screen instruments, DOT-approved breath-alcohol device, exam tables, EMR hardware) $60-$120K. Working capital (6-9 months operating expense pre-stabilization) $120-$300K. NRCME-certified examiner retention (signing bonus + first-quarter compensation if hired vs. founder-operator path) $0-$50K. Licensure + credentialing + startup professional fees $10-$30K.

• Lexington households with a primary earner commuting to TMMK Georgetown and the Tier-1 and Tier-2 suppliers

  Patient-side demand anchor (not TMMK procurement)

  Institution

  Working range of 2,900 to 6,900 Fayette workers in the Toyota geometry with a midpoint near 4,000 to 5,000 against LEHD OnTheMap; 9,000 to 18,000 Fayette household members in the labor shed at standard multipliers.
• TMMK Team Member Services and Tier-1 supplier-plant employer-benefits administrators (Toyota Boshoku, Trim Masters, Hitachi Astemo, Toyota Tsusho America, Yokohama Industries, Aisin, DENSO, Tokai Rika)

  Patient-referral channel (not a procurement target)

  Out-of-county

  The clinic is a Lexington-side patient-convenience option for Team Members on DOT recertification, workers'-comp follow-up, and post-incident screening near their Lexington home. The operator does not bid for procurement and does not position itself as a Toyota-credentialed vendor. TMMK is a Scott County employer, not a Fayette anchor.
• FCPS bus operations, LFUCG Public Works fleet, LexTran, FedEx Ground LEX, Amazon LEX1, UPS Lexington, and regional LTL carriers (Saia, Estes, Old Dominion)

  Non-Toyota DOT physical and drug-screen demand

  Institution

  Lexington DOT-physical demand across all sources substantially exceeds the Toyota commuter pool alone. FCPS bus operations runs 700 to 900 drivers.
• Lexmark, Trane, Link-Belt, Big Ass Fans, Tempur Sealy production sites, and Henkel Lexington

  OSHA surveillance, respirator clearance, and workers'-comp demand

  Institution

  Several Lexington industrial employers run respirator or hearing-conservation programs. The same NRCME credential and OSHA-surveillance protocols serve this employer set without re-credentialing.
• Concentra, US HealthWorks, Norton Healthcare Occupational Health, UK HealthCare Occupational Medicine, Baptist Health Lexington Occupational Health, and CHI Saint Joseph Occupational Health

  Incumbent occupational-medicine set

  Out-of-county

  The market-incumbent set the operator studies. UK Occupational Medicine is the most likely referral partner. The operator does not characterize incumbent business practice, pricing, quality of care, or competitive posture beyond factual reference.
• Quest Diagnostics and LabCorp

  SAMHSA-certified analytical lab partners

  Out-of-county

  The SAMHSA-certified lab is the analytical partner; the clinic is the collection site. Specimen-courier service-level terms and lab-account requirements remain to be confirmed.
• FMCSA NRCME, KY Board of Medical Licensure, KY Board of Nursing, KY Department of Workers' Claims, and KEMI (Kentucky Employers' Mutual Insurance)

  Federal, state credential, and workers'-comp payer authorities

  Out-of-county

  FMCSA administers NRCME. KBML, KBN, and the KBML PA Committee administer state licensure. KY DWC administers workers'-comp credentialing. KEMI is the largest Kentucky workers'-comp carrier and the primary network gate for workers'-comp provider referrals.
• Bluegrass Community and Technical College Healthcare programs, the Lexington-Fayette County Health Department, the Kentucky Council of Economic Development workforce liaison, and the Bluegrass Area Development District

  Talent pipeline, civic, and Tier-2 supplier introduction channels

  Institution

  BCTC supplies the medical assistant and LPN pipeline for chair-side staff. LFCHD covers local public-health relationships. KCED and BGADD carry Tier-2 supplier-plant HR contact lists.

Primary lane — NRCME-certified MD, DO, APRN, or PA founder-operator launching a corridor clinic. The founder personally holds NRCME certification, holds eligibility under Kentucky scope-of-practice, and runs the chair-side service themselves through Year 1. The lane is service-procedural and credential-gated; founder-operator economics carry the strongest take-home math.

Secondary lane — a returning-home primary-care or occupational-health physician building an independent practice. A Fayette-native former primary-care MD or DO or family-practice APRN with prior occ-med exposure who completes NRCME certification as part of the practice launch. Adds the corridor-positioning + employer-side relationship-build that a hospital-system primary-care expansion does not match.

Tertiary lane — an existing single-site occ-med operator adding the Fayette I-75 corridor. The Quest / LabCorp account, MRO contract, EMR, drug-screen-collection workflow, and OSHA-surveillance protocols are already in place; the lane addition is a Fayette-resident corridor clinic with NRCME-certified examiner retention plus employer-side contracts plus Lexington-corridor lease.

Toyota-side positioning discipline. Outreach to TMMK Team Member Services and to Tier-1 supplier-plant employer-benefits administrators is strictly a patient-convenience-clinic-available-to-Team-Members positioning — never 'Toyota supplier' or 'Toyota-credentialed occ-med vendor' or any positioning that misrepresents the relationship. Any marketing copy overstating a Toyota relationship can trigger Toyota legal correspondence and erase the patient-referral channel overnight.

Insurance-network credentialing. KEMI and the top-3 commercial W/C carriers credential providers on a 9-18 month cycle. Open KEMI plus the top-3 commercial W/C carrier applications in the pre-launch phase to compress the credentialing ramp.

Defamation discipline. Named incumbents (Concentra, US HealthWorks, Norton Healthcare Occupational Health, UK HealthCare Occupational Medicine, Baptist Health Lexington Occupational Health, CHI Saint Joseph Occupational Health) are referenced factually as the market-incumbent set. No characterization of their business practice, pricing, quality of care, or competitive posture. Named lab partners (Quest Diagnostics, LabCorp) and named W/C carrier (KEMI) are referenced as operational-configuration factual reference, not characterized.

• — LEHD OnTheMap commuter-flow tables for Fayette to Scott, Bourbon, Woodford, Harrison, and Franklin at the most-recent LODES vintage.
• — KCED workforce-development analyses of the Fayette-Scott labor pair; the 2026 TMMK, Tier-1, and Tier-2 supplier roster with plant locations and employment counts at toyotaky.com/suppliers.
• — TMMK and Tier-1 shift schedules and Saturday mandatory-overtime cadence for 2026; the 2026 TMMK EV-transition and retooling timeline and the projected Fayette workforce impact.
• — Concentra Lexington addresses, service hours, rate cards, and corridor positioning; Norton Healthcare Occupational Health Lexington footprint.
• — UK HealthCare Occupational Medicine program scope, external-employer-contract appetite, and potential referral or non-compete relationship.
• — Baptist Health Lexington Occupational Health and CHI Saint Joseph Occupational Health scope; independent single-site Lexington occupational-medicine and urgent-care operators on the I-75 / New Circle corridor.
• — Current Kentucky-market published rate cards for DOT physicals, drug-screen collections, OSHA surveillance, and workers'-comp visits.
• — FCPS bus operations driver count and DOT-physical recertification cadence; KEMI and top-3 commercial workers'-comp carrier provider-credentialing requirements and timeline.
• — NRCME-certified medical examiner Kentucky-market total-compensation comparables; Kentucky Board of Medical Licensure scope confirmation for APRN and PA DOT-physical performance.
• — Commercial real-estate availability and lease comps on the I-75 / New Circle corridor at the four candidate exits — Newtown Pike, North Broadway, Russell Cave / Bryan Station, and Winchester Road.
• — Quest Diagnostics and LabCorp Kentucky-market specimen-courier service-level terms and lab-account requirements; the MRO-services contracting market in Kentucky.
• — Tier-2 supplier-plant Fayette-resident hire-cycle volume for pre-employment drug-screen demand sizing.
• — Toyota Team Member discount-program and Tier-1 employee-benefits-portal vendor-onboarding mechanics on the patient-referral channel — not procurement.
• — Defamation-and-trademark review of any Toyota-adjacent marketing language before any launch communications.

Tonight, this week, this month — in that order. Each step produces a yes/no or a number, not a deeper understanding.