Document:

EX-4.8

 Exhibit 4.8 

TWENTY-SECOND SUPPLEMENTAL INDENTURE 

TWENTY-SECOND SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of September 15, 2015, among INSTANT TECH
SUBSIDIARY ACQUISITION INC. (the “New Guarantor”), which is a Subsidiary of Alere Inc. (the “Issuer”), ALERE INC., a Delaware corporation, each of the existing Guarantors (the “Existing Guarantors”)
under the Indenture referred to below, and U.S. BANK NATIONAL ASSOCIATION, as Trustee under the Indenture referred to below (the “Trustee”). 

WITNESSETH: 
 WHEREAS the Issuer
has heretofore executed and delivered an Indenture dated as of May 12, 2009, as amended, supplemented and modified by a Twenty-First Supplemental Indenture dated as of June 24, 2015 (as so amended, supplemented and modified, and as further
amended, supplemented or modified to date, the “Indenture”), by and among the Issuer, the Existing Guarantors and the Trustee, providing for the issuance of 6.375% Senior Subordinated Notes due 2023 (the “Notes”);

 WHEREAS Section 4.13 of the Indenture provides that under certain circumstances the Issuer is required to cause the New Guarantor to
execute and deliver to the Trustee a supplemental indenture pursuant to which the New Guarantor shall unconditionally and irrevocably guarantee all of the Issuer’s obligations under the Notes pursuant to a guarantee on the terms and conditions
set forth herein; and 
 WHEREAS pursuant to Section 9.01 of the Indenture, the Trustee, the Issuer and the Existing Guarantors are
authorized to execute and deliver this Supplemental Indenture; 
 NOW THEREFORE, in consideration of the foregoing and for other good and
valuable consideration, the receipt of which is hereby acknowledged, the New Guarantor, the Trustee, the Issuer and the Existing Guarantors mutually covenant and agree for the equal and ratable benefit of the Holders as follows: 

SECTION 1. Definitions. For all purposes of this Supplemental Indenture, except as otherwise herein expressly provided or unless the
context otherwise requires: (i) the terms and expressions used herein shall have the same meanings as corresponding terms and expressions used in the Indenture; and (ii) the words “herein,” “hereof” and
“hereby” and other words of similar import used in this Supplemental Indenture refer to this Supplemental Indenture as a whole and not to any particular section hereof. 

SECTION 2. Agreement to Guarantee. The New Guarantor hereby unconditionally and irrevocably agrees, jointly and severally with all
other Guarantors, to guarantee the Issuer’s obligations under the Notes and the Indenture on the terms and subject to the conditions set forth in Article Eleven of the Indenture and to be bound by all other applicable provisions of the
Indenture. 
 SECTION 3. Ratification of Indenture; Supplemental Indenture Part of Indenture. Except as expressly amended hereby, the
Indenture is in all respects ratified and confirmed and all the terms, conditions and provisions thereof shall remain in full force and effect. This Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of
Notes heretofore or hereafter authenticated and delivered shall be bound hereby. 

 SECTION 4. Governing Law. This Supplemental Indenture shall be governed by, and
construed in accordance with, the laws of the State of New York, but without giving effect to applicable principles of conflicts of laws to the extent that the application of the laws of another jurisdiction would be required thereby. 

SECTION 5. Trustee Makes No Representation. The Trustee makes no representation as to the validity or sufficiency of this Supplemental
Indenture or as to the recitals contained herein. 
 SECTION 6. Counterparts. The parties may sign any number of copies of this
Supplemental Indenture. Each signed copy shall be an original, but all of them together represent the same agreement. 
 SECTION 7.
Effect of Headings. The Section headings herein are for convenience only and shall not affect the construction thereof. 

[Signature Page Follows] 

  
 - 2 - 

 IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly
executed as of the date first above written. 
  

			
	 NEW GUARANTOR:
  

INSTANT TECH SUBSIDIARY ACQUISITION     INC.

		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	Title:	 	Assistant Secretary
	
	 ISSUER:
  

ALERE INC.

		
	By:	 	/s/ James F. Hinrichs
	Name:	 	James F. Hinrichs
	Title:	 	 Executive Vice President and
 Chief Financial
Officer

 Signature Page to Twenty-Second Supplemental Indenture 

 
			
	 EXISTING GUARANTORS:
  

ALERE CONNECT, LLC
 ALERE HOLDCO, INC.

ALERE HOME MONITORING, INC.
 ALERE INFORMATICS, INC.

ALERE INTERNATIONAL HOLDING CORP.
 ALERE NORTH AMERICA, LLC

ALERE SAN DIEGO, INC.
 ALERE SCARBOROUGH, INC.

ALERE TOXICOLOGY, INC.
 ALERE TOXICOLOGY SERVICES, INC.

ALERE US HOLDINGS, LLC
 AMEDITECH INC.

ATS LABORATORIES, INC.
 AVEE LABORATORIES INC.

BIOSITE INCORPORATED
 ESCREEN, INC.

GLOBAL ANALYTICAL DEVELOPMENT LLC
 INNOVACON, INC.

INSTANT TECHNOLOGIES, INC.
 IONIAN TECHNOLOGIES, LLC

LABORATORY SPECIALISTS OF AMERICA,     INC.

PEMBROOKE OCCUPATIONAL HEALTH, INC.
 QUALITY ASSURED SERVICES,
INC.
 REDWOOD TOXICOLOGY LABORATORY, INC.
 RTL HOLDINGS,
INC.
 STANDING STONE, LLC

		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	Title:	 	Assistant Secretary
	
	 FIRST CHECK DIAGNOSTICS, LLC

INVERNESS MEDICAL, LLC

		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	Title:	 	Secretary
	
	 SELFCARE TECHNOLOGY, INC.

		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	Title:	 	President

 Signature Page to Twenty-Second Supplemental Indenture 

 
			
	 TRUSTEE:
  

U.S. BANK NATIONAL ASSOCIATION,
 as Trustee

		
	By:	 	/s/ Gagendra Hiralal
	Name:	 	Gagendra Hiralal
	Title:	 	Assistant Vice President

 Signature Page to Twenty-Second Supplemental IndentureEX-4.14

 Exhibit 4.14 

NINETEENTH SUPPLEMENTAL INDENTURE 

NINETEENTH SUPPLEMENTAL INDENTURE (this “Supplemental Indenture”), dated as of September 15, 2015, among INSTANT TECH
SUBSIDIARY ACQUISITION INC. (the “New Guarantor”), which is a Subsidiary of Alere Inc. (the “Issuer”), ALERE INC., a Delaware corporation, each of the existing Guarantors (the “Existing
Guarantors”) under the Indenture referred to below, and THE BANK OF NEW YORK MELLON TRUST COMPANY, N.A., as Trustee under the Indenture referred to below (the “Trustee”). 

WITNESSETH: 
 WHEREAS the Issuer
has heretofore executed and delivered an Indenture dated as of August 11, 2009, as amended, supplemented and modified by a Fifteenth Supplemental Indenture dated as of December 11, 2012, a Sixteenth Supplemental Indenture dated as of April 3, 2013,
a Seventeenth Supplemental Indenture dated as of June 5, 2014, and an Eighteenth Supplemental Indenture dated as of October 30, 2014 (as so amended, supplemented and modified, and as further amended, supplemented or modified to date, the
“Indenture”), by and among the Issuer, the Existing Guarantors and the Trustee, providing for the issuance of 7.250% Senior Notes due 2018 (the “Notes”); 

WHEREAS Section 4.13 of the Indenture provides that under certain circumstances the Issuer is required to cause the New Guarantor to execute
and deliver to the Trustee a supplemental indenture pursuant to which the New Guarantor shall unconditionally and irrevocably guarantee all of the Issuer’s obligations under the Notes pursuant to a guarantee on the terms and conditions set
forth herein; and 
 WHEREAS pursuant to Section 9.01 of the Indenture, the Trustee, the Issuer and the Existing Guarantors are authorized
to execute and deliver this Supplemental Indenture; 
 NOW THEREFORE, in consideration of the foregoing and for other good and valuable
consideration, the receipt of which is hereby acknowledged, the New Guarantor, the Trustee, the Issuer and the Existing Guarantors mutually covenant and agree for the equal and ratable benefit of the Holders as follows: 

SECTION 1. Definitions. For all purposes of this Supplemental Indenture, except as otherwise herein expressly provided or unless
the context otherwise requires: (i) the terms and expressions used herein shall have the same meanings as corresponding terms and expressions used in the Indenture; and (ii) the words “herein,” “hereof” and “hereby” and
other words of similar import used in this Supplemental Indenture refer to this Supplemental Indenture as a whole and not to any particular section hereof. 

SECTION 2. Agreement to Guarantee. The New Guarantor hereby unconditionally and irrevocably agrees, jointly and severally with all
other Guarantors, to guarantee the Issuer’s obligations under the Notes and the Indenture on the terms and subject to the conditions set forth in Article Ten of the Indenture and to be bound by all other applicable provisions of the Indenture.

 SECTION 3. Ratification of Indenture; Supplemental Indenture Part of Indenture. Except as expressly amended hereby, the
Indenture is in all respects ratified and confirmed and all the terms, conditions and provisions thereof shall remain in full force and effect. This Supplemental Indenture shall form a part of the Indenture for all purposes, and every Holder of
Notes heretofore or hereafter authenticated and delivered shall be bound hereby. 
  

 SECTION 4. Governing Law. This Supplemental Indenture shall be governed by, and
construed in accordance with, the laws of the State of New York, but without giving effect to applicable principles of conflicts of laws to the extent that the application of the laws of another jurisdiction would be required thereby. 

SECTION 5. Trustee Makes No Representation. The Trustee makes no representation as to the validity or sufficiency of this
Supplemental Indenture or as to the recitals contained herein. 
 SECTION 6. Counterparts. The parties may sign any number of
copies of this Supplemental Indenture. Each signed copy shall be an original, but all of them together represent the same agreement. 

SECTION 7. Effect of Headings. The Section headings herein are for convenience only and shall not affect the construction thereof.

 [Signature Page Follows] 

  
 -2- 

 IN WITNESS WHEREOF, the parties hereto have caused this Supplemental Indenture to be duly
executed as of the date first above written. 
  

			
	NEW GUARANTOR:
	
	 INSTANT TECH SUBSIDIARY ACQUISITION INC.

		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	Title:	 	Assistant Secretary
	
	ISSUER:
	
	 ALERE INC.

		
	By:	 	/s/ James F. Hinrichs
	Name:	 	James F. Hinrichs
	Title:	 	 Executive Vice President and
 Chief Financial
Officer

  
 Signature Page to
Nineteenth Supplemental Indenture 

 
			
	EXISTING GUARANTORS:
	
	 ALERE CONNECT, LLC

	 ALERE HOLDCO, INC.

	 ALERE HOME MONITORING, INC.

	 ALERE INFORMATICS, INC.

	 ALERE INTERNATIONAL HOLDING CORP.

	 ALERE NORTH AMERICA, LLC

	ALERE SAN DIEGO, INC.
	ALERE SCARBOROUGH, INC.
	 ALERE TOXICOLOGY, INC.

	 ALERE TOXICOLOGY SERVICES, INC.

	ALERE US HOLDINGS, LLC
	AMEDITECH INC.
	 ATS LABORATORIES, INC.

	AVEE LABORATORIES INC.
	BIOSITE INCORPORATED
	 ESCREEN, INC.

	 GLOBAL ANALYTICAL DEVELOPMENT LLC

	 INNOVACON, INC.

	 INSTANT TECHNOLOGIES, INC.

	IONIAN TECHNOLOGIES, LLC
	LABORATORY SPECIALISTS OF AMERICA, INC.
	PEMBROOKE OCCUPATIONAL HEALTH, INC.
	QUALITY ASSURED SERVICES, INC.
	REDWOOD TOXICOLOGY LABORATORY, INC.
	RTL HOLDINGS, INC.
	STANDING STONE, LLC
		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	Title:	 	Assistant Secretary
	
	FIRST CHECK DIAGNOSTICS, LLC
	INVERNESS MEDICAL, LLC
		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	 Title:
	 	 Secretary

	
	SELFCARE TECHNOLOGY, INC.
		
	By:	 	/s/ Douglas John Barry
	Name:	 	Douglas John Barry
	 Title:
	 	 President

  
 Signature Page to
Nineteenth Supplemental Indenture 

 
			
	TRUSTEE:
	
	THE BANK OF NEW YORK MELLON TRUST COMPANY, N.A.,
	 as Trustee

		
	By:	 	/s/ Lawrence M. Kusch
		 	 Name: Lawrence M. Kusch

		 	 Title: Vice President

  
 Signature Page to
Nineteenth Supplemental Indenture

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