All of Us Biobank - In 2017, the All of Us (AoU) Research Program was established to realize the ambitious goals set out by the Precision Medicine Initiative proposal. The goal of the AoU Research Program is to enroll one million people living in the U.S. into a national cohort that broadly represents the U.S. population and to accelerate progress toward a new era of precision medicine on a larger scale than previously possible. Over the course of the past 7 years, the AoU Research Program has enrolled 848,783 participants with 608,145 providing biospecimens, resulting in 3,959,288 samples collected and 14,521,323 aliquots created and stored at the AoU Biobank housed within the Mayo Clinic Biorepositories Program. The Mayo Clinic Biorepositories Program is CAP accredited and has biobanking activities established at all three Mayo Clinic sites (Rochester, MN, Jacksonville, FL, and Phoenix, AZ). Mayo Clinic has been an integral member of the AoU team since its inception, supporting the AoU Research Program through input on program development and execution of all activities related to biospecimen collection, processing, storage, distribution, and management. The objective of this new proposal is to continue utilizing the full resources available through the Mayo Clinic Biorepositories Program to efficiently and cost effectively support the AoU Research Program in innovative ways with respect to AoU Biobanking activities, namely: biospecimen collection, kit assembly, biospecimen shipping, receipt, accessioning, tracking, processing, quality assurance, storage, and distribution. Mayo Clinic Laboratories in Rochester MN, the third largest reference laboratory in the United States, will continue to support AoU Biobank activities by enabling efficient specimen transportation and routing between AoU collection sites and the AoU Biobank at Mayo Clinic. While Mayo Clinic Rochester will continue to serve as the primary site for AoU Biobank activities, the biorepository group at Mayo Clinic Jacksonville will continue to provide support as the secondary site for sample storage, ensuring that a subset of the cohort is available as a backup. The specific aims of this proposal are to: 1) Maintain Existing Biospecimens and Sustain Biobank Operations; 2) Support Biobank Expansion Initiatives, Including Pediatric, Reassessment, and Ancillary Studies; and 3) Provide Ongoing Collaboration and Support for the AoU Research Program. Overall, the combined capabilities and facilities available through the Mayo Clinic Biorepositories Program and Mayo Clinic Laboratories provide an unparalleled ability to collect, accession, process, distribute, store, and manage virtually any type of biospecimen, while maintaining the highest standards for biospecimen quality. As demonstrated over the course of the past 7 years, we have the capacity and the proven capabilities to support all new initiatives on behalf of the AoU Research Program.