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Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2021
Dec. 31, 2020
Dec. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES      
NET (LOSS) INCOME $ (8,347) $ 4,172 $ 8,006
Adjustments to reconcile net (loss) income to net cash provided by operating activities:      
Depreciation 30,192 25,904 20,346
Amortization of intangibles 23,160 9,817 9,925
Non-cash stock-based compensation 22,458 10,212 10,000
Non-cash operating lease expense 8,716 6,168 5,635
Amortization of convertible debt discount 2,563 4,358 0
Amortization of debt issuance costs 178 165 390
Loss on debt extinguishment 0 1,400 1,018
Loss on termination of cash flow hedge 0 3,506 0
Gain on investment in and loan receivable from non-consolidated affiliate, net (109,260) (3,955) 0
Interest on loan receivable from non-consolidated affiliate (391) 0 0
Write off of COVID-19 PCR testing inventory and equipment 6,061 0 0
Other non-cash items 2,547 1,460 472
Changes in assets and liabilities, net:      
Accounts receivable, net (4,691) (12,601) (17,301)
Inventories 1,634 (15,197) (5,754)
Prepaid lease asset (4,788) (20,229) 0
Prepaid and other assets (1,906) (9,750) (367)
Accounts payable, operating lease liabilities, deferred taxes, accrued and other liabilities 5,151 (3,970) (9,001)
Net cash (used in) provided by operating activities (26,723) 1,460 23,369
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchases of marketable securities (196,791) (73,101) 0
Proceeds from sales and maturities of marketable securities 62,970 5,356 0
Purchases of property and equipment (64,142) (29,096) (20,029)
Business acquisitions, net of cash acquired (419,404) (37,000) 0
Investment in non-consolidated affiliate 0 (25,600) 0
Loan receivable from non-consolidated affiliate (15,000) 0 0
Acquisition working capital adjustment 0 0 399
Net cash used in investing activities (632,367) (159,441) (19,630)
CASH FLOWS FROM FINANCING ACTIVITIES      
Repayment of revolving credit facility 0 0 (5,000)
Repayment of equipment financing obligations (3,047) (5,615) (7,201)
Proceeds from term loan 0 0 100,000
Repayment of term loan 0 (97,540) (99,250)
Cash flow hedge termination 0 (3,317) 0
Payments of debt issuance costs for term loan 0 0 (1,059)
Issuance of common stock, net 15,080 20,310 11,202
Proceeds from issuance of convertible debt, net of issuance costs 334,410 194,466 0
Premiums paid for capped call transactions (29,291) 0 0
Proceeds from equity offering, net of issuance costs 408,133 127,293 160,774
Net cash provided by financing activities 725,285 235,597 159,466
Net change in cash and cash equivalents 66,195 77,616 163,205
Cash and cash equivalents, beginning of year 250,632 173,016 9,811
Cash, cash equivalents and restricted cash, end of year 316,827 250,632 173,016
Cash and cash equivalents 316,827 228,713 173,016
Restricted cash 0 21,919 0
Supplemental disclosure of cash flow information:      
Interest paid 3,065 2,926 4,775
Income taxes paid, net 148 246 319
Supplemental disclosure of non-cash investing and financing information:      
Fair value of common stock issued to fund acquisition 29,174 0 0
Working capital adjustment related to acquisition 0 0 1,977
Equipment acquired under financing obligations 0 428 4,283
Property and equipment included in accounts payable $ 1,315 $ 2,007 $ 1,034