Labcorp has agreed to buy the remaining diagnostic testing operations of OPKO Health's BioReference Health unit in a deal worth up to $872 million, closing out a three-year sell-off that has seen the Burlington, North Carolina-based lab giant absorb the New Jersey testing company piece by piece. OPKO Health shares rose 20% in premarket trading on the news, which values the deal at $722 million in upfront cash plus a potential $150 million earnout tied to future performance of a prostate cancer test.
As reported by Reuters, Labcorp will acquire BioReference's clinical diagnostics, women's health, urology, and corrections testing businesses, along with more than 80 patient service centers and other operating assets. The deal also hands Labcorp ownership of BioReference's 4Kscore test, which is used to assess the likelihood of aggressive prostate cancer before a patient undergoes a biopsy. That test alone generated $27.1 million in revenue in 2025, according to the same Reuters report, making the tied earnout a meaningful incentive for Labcorp to grow it further.
A Three-Year Unwinding of a $1.2 Billion Bet
Thursday's agreement marks the third asset buyout between Labcorp and OPKO Health for BioReference units in less than three years, following a $237.5 million purchase of regional clinical assets in March 2024 and a $225 million acquisition of BioReference's oncology testing business completed in September 2025, according to the South Florida Business Journal. Those earlier sales left OPKO holding BioReference's core New York and New Jersey clinical operations and its urology business before the Miami-based company moved to sharpen its focus on biopharmaceuticals.
OPKO originally acquired Elmwood Park, New Jersey-based BioReference Laboratories in August 2015 for roughly $1.2 billion to $1.5 billion, building out a diagnostic testing infrastructure meant to commercialize proprietary tests like 4Kscore, per MedTech Dive. BioReference had operated in Elmwood Park for more than four decades as one of the largest full-service clinical diagnostic laboratories in the country, per PitchBook.
Frost Points to Biopharma Pipeline
OPKO Health Chairman and CEO Dr. Phillip Frost said Thursday that selling BioReference's remaining testing operations allows OPKO to streamline its business, eliminate laboratory testing exposure, and channel proceeds into its biopharmaceutical pipeline. Per Reuters, OPKO said the sale will sharpen its focus on its biopharmaceutical business, which includes the FDA-approved kidney disease therapy Rayaldee. OPKO Health is based in Miami.
Labcorp said it expects the acquired businesses to generate about $250 million in revenue in their first year after closing, compared with an estimated $85 million to $100 million in annual revenue for the acquired assets. The transaction still requires regulatory clearance and other closing conditions, and Labcorp and OPKO have not provided an expected closing date, per Reuters.
Deal Advisors and Corporate Scale
Financial advisory for the transaction was led by Lazard for Labcorp and Piper Sandler & Co. for OPKO Health, with legal counsel provided by Hogan Lovells and Cadwalader US LLP for Labcorp and Greenberg Traurig P.A. for OPKO, according to a statement carried by Investing.com. Labcorp operated with nearly 71,000 employees across roughly 100 countries during 2025, performing more than 750 million patient tests globally and supporting the development of over 85% of FDA-approved new drugs, CityBiz reports.
Labcorp's Scale Advantage
In September, the Centers for Medicare & Medicaid Services released preliminary 2027 Clinical Laboratory Fee Schedule payment rates proposing reimbursement reductions of up to 15% across nearly 1,200 laboratory tests. Under the Protecting Access to Medicare Act, Medicare resets those fee schedule rates every three years using weighted median private-payor rate data collected from independent, hospital outreach, and physician office laboratories, according to CMS.
Labcorp's acquisition of BioReference's remaining testing footprint highlights the scale advantages of national laboratory networks, consolidating regional volume into one of the largest lab networks in the country.
