An integrated medical testing device includes a testing meter and lancing device, the meter having a housing, a display, a test element opening, a firing mechanism and a navigation mechanism integrated with a lancing device. The lancing device is at least partially located in the housing and includes a tip having an opening through which a lancet extends upon firing. Various mechanisms can be used to extend the tip from the housing and to prime and fire the lancing device. The lancing device can accommodate a single lancet or a cartridge having multiple lancets. If a cartridge is used, various mechanisms can be utilized to position an unused lancet for firing after a test has been conducted. The relative locations of the lancing device and test element opening are such that the integrated meter and lancing device can be used with a test element inserted in the test element opening. The integrated meter and lancing device can include status indicators that reflect the state of the lancing device.