[Googam]

As a Commercial real estate developer, I've been down this road many times & spent most of career doing medical office buildings. Meet with as many Design/Build contractors as you can stand. Tell them what you want are what you are trying to build. Based on experience, they should have a pretty good idea to begin with. Pick the one you feel the most comfortable with. They will have architects, mechanical contractors & engineers they work with. These guys will supply design services as part of their bid based on the architects design. Have your equipment supplier layout the various rooms, gas locations, plumbing, cabinetry & specialty services. The various firms will do their bids & spec drawings based on those. An architect can stamp these. You can have your contractor bid as many of these services as you want, within reason & the tolerance of the builder. The contractor should get paid on draws, based on work accomplished, he pays everyone else. It requires a fair amount of attention & involvement, but you'll know what you're getting & what you're paying for.