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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 |  |

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