Clinical Laboratory Services Markets 2027–2031

Clinical Laboratory Services Markets: Market Forecast, Competitive Landscape, Consolidation and Strategy, 2027–2031 (October 2026)

Global forecasts by test type, laboratory type, cost component, payer and clinical area, for 14 countries and regions, with 69 company profiles. Values are at the price paid for laboratory testing.

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Our Take

The clinical laboratory industry is consolidating around scale while its growth shifts to genes and molecules. The market grows from $210 billion in 2026 to $285 billion in 2031, at 6.3% a year. Molecular and genetic testing take over a third of the new spending, independent laboratories take over hospital outreach, and payment cuts and staff shortages squeeze margins on routine tests.

Market Size 2026: USD $210B Market Size 2031: USD $285B CAGR: 6.3%

Situation Analysis: what is really happening

• Genes and molecules lead the growth. Genetic & Genomic Testing grows 14.7% a year to $27,075 million and Molecular Diagnostics 10.1% a year to $35,625 million; together they take 36% of new spending. Clinical Chemistry & Immunoassay remains the largest test type, but its share falls from 40.5% to 36.5%.
• Independent labs take over outreach. Independent & Reference Labs grow 7.5% a year to $105,450 million and take 43% of the growth, as health systems sell or share their outreach businesses. Hospital Inpatient testing grows only 4.4% a year.
• Payment cuts are coming. Congress delayed PAMA cuts to 2027, but CMS's preliminary 2027 rates average about 16% below 2026, with cuts phased in at up to 15% a year. Public Insurance pays for 58.0% of testing by 2031.
• Oncology and new tests drive demand. Oncology is the fastest-growing clinical area at 9.2% a year and takes 32% of new spending, and the FDA cleared new Alzheimer's blood tests in August 2026.
• Costs shift away from instruments. Overhead & Other is the fastest-growing cost component at 8.9% a year, while Instruments grow only 2.8%. Labour remains the largest cost at $76,650 million in 2026.
• China grows fastest, South Korea slowest. China grows 8.8% a year from $18,493 million to $28,244 million despite test price cuts, and South Korea grows slowest at 2.4% a year. The USA reaches 43.0% of the market in 2031.

Company Analysis: who is positioned, who is exposed

• Quest Diagnostics: Second-quarter 2026 revenue rose 10.2% on 13.1% more requisitions, and Quest formed a joint laboratory with Corewell Health in Michigan.
• Labcorp: Agreed in October 2026 to buy BioReference's clinical, women's health and urology testing businesses from OPKO for $722 million plus an earnout.
• Sonic Healthcare, Synlab, Eurofins and Unilabs: The European and Australian groups continue to consolidate through acquisitions of regional laboratories.
• KingMed, Dian and Adicon: China's independent laboratory groups face test price cuts; KingMed's revenue fell by about 16% in 2025.
• Roche, Abbott, Siemens Healthineers and Sysmex: The analyser and reagent suppliers whose systems run in laboratories worldwide.
• Function Health and other consumer platforms: Consumer-initiated testing brings new volume to the large laboratories.

In all, 69 company profiles, each one to two pages with a fact box covering website, headquarters, ownership, revenue, employees and key products.

Questions this report answers

• How fast will genetic, genomic and molecular testing grow compared with routine testing?
• How much hospital outreach testing will move to independent and reference laboratories?
• What will the 2027 Medicare payment cuts mean for laboratory revenue?
• Which test types, clinical areas and payers will add the most new spending?
• Who are the leading laboratory groups, and what are laboratories selling for?
• How large is each country market, and how fast is China growing?

What's inside

• 394 pages, 24 chapters, 64 tables and 51 figures
• Forecasts for 2027–2031 from a 2026 base year, by test type, laboratory type, cost component, payer and clinical area, for 14 countries and regions
• Test menu and volume trends, hospital laboratories and outreach, technology, automation and AI, business models and consumer testing
• Regulation and reimbursement, pricing, costs and workforce, China and emerging markets, a deal database and laboratory operations
• 10 market-moving developments from 2025 and 2026, SWOT, Porter's Five Forces and strategic recommendations
• 69 company profiles
• Download the Table of Contents (PDF)

Who buys this report

• Laboratory executives and business development teams: size testing opportunities by test type, laboratory type and payer, and find acquisition and outreach targets.
• Health system leaders: decide whether to keep, share or sell outreach laboratory businesses.
• Investors and analysts: model laboratory growth, payment risk and consolidation and benchmark deal values.
• Diagnostics suppliers: judge demand for analysers, reagents, automation and laboratory software.

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ABOUT THE LEAD AUTHOR

Mr. Greg Powell, B.Sc., M.B.A., is the President of Howe Sound Research. His education includes:

Finance for Senior Executives - Harvard Business School

Market Research - Burke Institute

M.B.A. (Finance and Policy) - University of British Columbia

B.Sc. (Chemistry) - University of British Columbia

He is an experienced business and clinical professional. He is co-author of the paper "The Radioimmunoassay of Angiotensinogen by Antibody Trapping." He has worked in laboratory testing and management for over 20 years.