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Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Sep. 30, 2020
Dec. 31, 2019
Sep. 30, 2019
Dec. 31, 2018
Balance Sheet Components        
Reserves for refunds to insurance carriers $ 13,322 $ 9,410 $ 8,692 $ 10,012
Accrued charges for third-party testing 5,668 8,408    
Testing and laboratory materials from suppliers 8,618 4,301    
Marketing and corporate affairs 3,235 2,957    
Legal, audit and consulting fees 4,666 2,873    
Accrued shipping charges 745 305    
Sales tax payable 1,405 1,691    
Accrued specimen service fees 2,247 2,269    
Clinical trials and studies 1,828 1,092    
Operating lease liabilities, current portion 6,380 5,739    
Fixed asset purchases 1,959 1,482    
Other accrued interest 2,965      
Other accrued expenses 9,855 8,516    
Total other accrued liabilities $ 62,893 $ 49,043