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Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Sep. 30, 2021
Dec. 31, 2020
Sep. 30, 2020
Dec. 31, 2019
Balance Sheet Components        
Reserves for refunds to insurance carriers $ 15,879 $ 17,366 $ 13,322 $ 9,410
Accrued charges for third-party testing 17,690 5,141    
Testing and laboratory materials from suppliers 6,513 2,720    
Marketing and corporate affairs 6,152 3,325    
Legal, audit and consulting fees 15,215 4,189    
Accrued shipping charges 399 1,604    
Sales tax payable 1,758 1,723    
Accrued third-party service fees 3,363 2,355    
Clinical trials and studies 6,282 2,353    
Operating lease liabilities, current portion 6,922 7,300    
Fixed asset purchases 4,957 1,691    
Other accrued interest 2,695 1,078    
Other accrued expenses 8,661 9,562    
Total other accrued liabilities $ 96,486 $ 60,407