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BUSINESS ACQUISITIONS
 9 Months Ended
Sep. 30, 2026
Business Combination [Abstract]  
BUSINESS ACQUISITIONS AND DISPOSITIONS BUSINESS ACQUISITIONS
During the nine months ended September 30, 2026, the Company acquired various businesses and related assets for total consideration of $789.1, net of cash acquired and including measurement period adjustments. Total consideration included cash payments and, as applicable, contingent consideration payable by the Company primarily upon the achievement of specified future performance targets of the acquired businesses. The preliminary purchase price for each of these acquisitions was allocated under the acquisition method of accounting to the estimated fair market value of the net assets acquired. During the nine months ended September 30, 2026, the Company recorded $439.0 of goodwill, including measurement period adjustments, of which $223.2 was tax-deductible. The following table includes the preliminary purchase price allocations for these acquisitions at September 30, 2026, which may be revised as additional information becomes available during the measurement period:
Empire City Laboratories, Inc.Parkview Health Systems, Inc.MLM Medical LabsOther Acquisitions Closed During the Nine Months Ended September 30, 2026Measurement Period AdjustmentsAmounts Acquired During the Nine Months Ended September 30, 2026
Cash and cash equivalents$— $— $9.5 $0.4 $— $9.9 
Accounts receivable— — 12.3 3.6 — 15.9 
Unbilled services— — 2.9 — — 2.9 
Inventories— — 2.1 — — 2.1 
Prepaid expenses and other— — 0.8 — — 0.8 
Property, plant, and equipment— — 5.7 2.8 — 8.5 
Goodwill117.5 77.5 176.9 68.1 (1.0)439.0 
Intangible assets132.5 87.5 100.2 68.2 (13.1)375.3 
Other assets— — 0.7 — — 0.7 
Total assets acquired250.0 165.0 311.1 143.1 (14.1)855.1 
Accounts payable— — 2.6 2.5 — 5.1 
Accrued expenses and other— — 6.3 1.7 — 8.0 
Unearned revenue— — 4.9 — — 4.9 
Notes payable— — — 0.9 — 0.9 
Deferred tax liabilities— — 23.8 7.5 — 31.3 
Lease liabilities— — 3.5 2.4 — 5.9 
Total liabilities acquired— — 41.1 15.0 — 56.1 
Net assets acquired250.0 165.0 270.0 128.1 (14.1)799.0 
Contingent consideration(85.0)— (5.0)(4.8)14.1 (80.7)
2025 escrow payments— (5.0)— (20.0)— (25.0)
Cash paid for acquisitions$165.0 $160.0 $265.0 $103.3 $— $693.3 
Intangible assets recognized from business acquisitions that closed during the nine months ended September 30, 2026, including any related measurement period adjustments, and their weighted-average amortization periods were as follows:
Amount
Weighted-average Amortization Period
(in Years)
Customer relationships$335.3 15.0
Non-compete agreements48.9 5.0
Other4.2 5.0
   Total
$388.4 
On June 28, 2026, the Company entered into an agreement to acquire select assets of an outreach laboratory services business for a purchase price of approximately $155.0. The transaction is subject to customary closing conditions and applicable regulatory approvals for a transaction of this type.
On October 15, 2026, the Company announced that it entered into an agreement with OPKO Health, Inc. to acquire select assets of the laboratory business of BioReference Health, LLC, a wholly owned subsidiary of OPKO. Through this transaction, the Company will acquire BioReference Health’s laboratory testing businesses focused on clinical and women’s health testing services, urology, corrections, certain operational assets, including additional patient service centers, and the proprietary 4Kscore® Test, an FDA-approved blood test for prostate cancer. The estimated purchase price for the transaction is up to $872.0, including $722.0 payable in cash at closing and up to $150.0 of consideration contingent upon revenue from the 4Kscore® Test. This transaction is anticipated to close mid-2027, subject to regulatory approvals and customary closing conditions for a transaction of this type.
On October 20, 2026, the Company announced that it entered into an agreement to acquire the Prenatal Health testing business from Myriad Genetics, Inc. The estimated purchase price for this transaction is approximately $210.0 in cash, plus the value of the inventory of the Prenatal Health testing business at closing. The transaction is expected to close early 2027, subject to customary closing conditions and applicable regulatory approvals for a transaction of this type.
On October 23, 2026, the Company announced that it entered into an agreement to acquire Millennium Health, an accredited specialty laboratory with a focus on drug testing and surveillance. The estimated purchase price for the transaction is up to $375.0, including $245.0 payable in cash at closing and up to $130.0 of consideration contingent upon the outcome of specified future events. This transaction is anticipated to close in 2026, subject to regulatory approvals and customary closing conditions for a transaction of this type.
Unaudited Supplemental Pro Forma Information
If the aggregate of the Company’s 2026 and 2025 acquisitions, that were accounted for as business combinations, had been completed at January 1, 2025, the Company’s pro forma results would have been as follows:
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Revenues$3,819.1 $3,638.0 $11,139.0 $10,666.6 
Net earnings attributable to LHI$264.8 $270.9 $854.4 $748.3