Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Balance Sheet Components
Reserves for refunds to insurance carriers	$ 11,276	$ 23,245	$ 18,948
Accrued charges for third-party testing	12,321	14,823
Testing and laboratory materials from suppliers	7,893	11,229
Marketing and corporate affairs	16,548	10,085
Legal, audit and consulting fees	54,208	43,897
Accrued shipping charges	1,625	3,646
Sales and income tax payable	4,416	3,731
Accrued third-party service fees	9,046	7,111
Clinical trials and studies	10,097	12,126
Operating lease liabilities, current portion	10,168	11,621
Property and equipment purchases	7,098	4,316
Other accrued interest		1,078
Other accrued expenses	2,197	2,497
Total other accrued liabilities	$ 146,893	$ 149,405
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Total other accrued liabilities	Total other accrued liabilities
Accrued settlement liability	$ 12,600