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Balance Sheet Components - Other Accrued Liabilities (Details) - USD ($)
$ in Thousands
Mar. 31, 2025
Dec. 31, 2024
Mar. 31, 2024
Dec. 31, 2023
Balance Sheet Components        
Reserves for refunds to insurance carriers $ 10,171 $ 11,276 $ 18,023 $ 23,245
Accrued charges for third-party testing 16,963 12,321    
Testing and laboratory materials from suppliers 10,754 7,893    
Marketing and corporate affairs 17,898 16,548    
Legal, audit and consulting fees 66,097 54,208    
Accrued shipping charges 1,945 1,625    
Sales and income tax payable 5,602 4,416    
Accrued third-party service fees 8,812 9,046    
Clinical trials and studies 10,788 10,097    
Operating lease liabilities, current portion 12,199 10,168    
Property and equipment purchases 9,525 7,098    
Other accrued expenses 7,695 2,197    
Total other accrued liabilities $ 178,449 $ 146,893