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Balance Sheet Components - Other Accured Liabilities (Details) - USD ($)
$ in Thousands
1 Months Ended 9 Months Ended 12 Months Ended
Mar. 31, 2019
Sep. 30, 2019
Dec. 31, 2018
Mar. 07, 2018
Dec. 31, 2017
Balance Sheet Components          
Settlement accrued for reimbursement related claims     $ 1,378    
Reserves for refunds to third-party payers   $ 8,700 10,012    
Accrued charges for outsourced testing   6,199 5,001    
Testing and laboratory materials from suppliers   1,170 2,742    
Marketing and corporate affairs   2,430 1,306    
Legal, audit and consulting fees   1,516 1,058    
Accrued shipping charges     852    
Sales tax payable   1,021 1,255    
Accrued specimen service fees   1,386 1,378    
Accrued rent     903    
Clinical trials and studies   1,229 1,694    
Operating lease liabilities, current portion   5,536      
Other accrued expenses   9,515 4,863    
Total other accrued liabilities   38,702 32,442    
Accrued settlement liability     1,400 $ 11,400 $ 11,400
Settlement agreement, amount plus applicable interest to be paid in installments       $ 5,300  
Additional reserves for refunds to insurance carriers   7,200      
Settlement agreement installment paid $ 1,400   $ 10,300    
Revenue recognized   1,000      
Overpayments from insurance carriers   $ 8,500