Introduction The high incidence of viral hepatitis in the Republic of Sakha (Yakutia) requires an effective system of laboratory diagnostics, the availability of which is uneven due to the vast territory and climatic and geographical features of the region. Objective The aim of the study is to analyze the potential of medical organizations in the Republic of Sakha (Yakutia) to detect viral hepatitis based on an assessment of the implementation of diagnostic methods, technical equipment and staffing. Materials and methods A retrospective analysis of data from Federal Statistical Observation Form No. 30 “Information on a Medical Organization” was conducted for the period 2015–2024. Medical organizations were stratified into six administrative-territorial zones. Descriptive statistics and comparative analysis methods were applied. Results A significant territorial disproportion was revealed. In the Arctic zone, ELISA diagnostics is available in only 38.47% of central district hospitals, and PCR studies are not performed in any of the districts. In Yakutsk and the Southern zone, ELISA coverage is 100%, and PCR diagnostics covers up to 93.34% of organizations. High equipment wear was identified (100% of sequencers have been in operation for more than 7 years). Staffing of the laboratory service in sparsely populated districts remains insufficient. Discussion The revealed territorial disproportion indicates high risks of hidden spread of infection in remote areas. The absence of PCR diagnostics throughout the entire Arctic zone makes it impossible to promptly perform confirmatory tests for patients with positive primary screening results. This prolongs the time to initiate antiviral therapy and increases the risks of infection transmission. The established correlation between the technical equipment of laboratories and the registered incidence (especially among the pediatric population in the Western zone) confirms that low epidemiological indicators in peripheral zones are due to insufficient testing coverage, rather than actual well-being. Modernization of the service requires systemic solutions: centralization of PCR studies with optimized logistics of biological material, implementation of telemedicine consultations, and programs for retaining personnel in remote territories. Conclusions To increase the detection rate of viral hepatitis in the Republic of Sakha (Yakutia), a systematic modernization of the laboratory service is necessary. Priority tasks include eliminating the deficit of PCR diagnostics in remote areas, updating worn-out equipment, and strengthening the staffing potential of peripheral medical organizations.