> If you can't be bothered to take some basic steps for web site scaling (google page speed + a CDN) then the idea that you will carefully and successfully navigate to a 1 million tests per day moderate to high complexity medical test seems like it will be a stretch no?

No. :)

Seriously, these are orthogonal skills. I briefly worked for a communications satellite company that had a pretty godawful web site, but I doubt any of their prospective customers visited it and said, "Wow, if these people can't design a good looking web page, how can we trust them to put a satellite in orbit?"

One reason that argument doesn't work is the effects of focus. When you're intensely focused on something, momentum builds up that is like a high-speed train. You can't do nimble switching, even to easier things. One might imagine that they'd forget to, say, pay a utility bill as well.

(I have no inside information and am simply guessing based on past experience with unrelated things.)

"If you can't be bothered to take some basic steps for web site scaling (google page speed + a CDN) then the idea that you will carefully and successfully navigate to a 1 million tests per day moderate to high complexity medical test seems like it will be a stretch no? "

Their priorities may be on other things than websites.