NeoGenomics (NEO) 10-Q 8 Nov 22 2022 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2022	Nov. 04, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
Document Transition Report	false
Entity File Number	001-35756
Entity Registrant Name	NEOGENOMICS, INC.
Entity Incorporation, State or Country Code	NV
Entity Tax Identification Number	74-2897368
Entity Address, Address Line One	9490 NeoGenomics Way,
Entity Address, City or Town	Fort Myers,
Entity Address, State or Province	FL
Entity Address, Postal Zip Code	33912
City Area Code	(239)
Local Phone Number	768-0600
Title of 12(b) Security	Common stock ($0.001 par value)
Trading Symbol	NEO
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		126,303,261
Entity Central Index Key	0001077183
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Current assets
Cash and cash equivalents	$ 266,126	$ 316,827
Marketable securities, at fair value	177,414	198,563
Accounts receivable, net	111,994	112,130
Inventories	23,799	23,395
Prepaid assets	16,511	12,354
Assets held for sale	0	10,050
Other current assets	7,516	8,189
Total current assets	603,360	681,508
Property and equipment (net of accumulated depreciation of $125,018 and $109,952, respectively)	106,818	109,465
Operating lease right-of-use assets	98,945	102,197
Intangible assets, net	416,848	442,325
Goodwill	522,766	527,115
Other assets	6,845	7,168
Total non-current assets	1,152,222	1,188,270
Total assets	1,755,582	1,869,778
Current liabilities
Accounts payable	13,708	17,921
Accrued compensation	37,992	38,304
Accrued expenses and other liabilities	20,420	17,796
Current portion of equipment financing obligations	118	1,135
Current portion of operating lease liabilities	6,379	6,884
Pharma contract liabilities	6,386	5,192
Total current liabilities	85,003	87,232
Long-term liabilities
Convertible senior notes, net	534,609	532,483
Operating lease liabilities	70,471	72,289
Deferred income tax liabilities, net	38,345	55,475
Other long-term liabilities	14,166	14,022
Total long-term liabilities	657,591	674,269
Total liabilities	742,594	761,501
Commitments and contingencies (Note 11)
Stockholders’ equity
Common stock, $0.001 par value, (250,000,000 shares authorized; 126,562,037 and 124,107,500 shares issued and outstanding, respectively)	127	124
Additional paid-in capital	1,154,365	1,123,628
Accumulated other comprehensive loss	(5,104)	(638)
Accumulated deficit	(136,400)	(14,837)
Total stockholders’ equity	1,012,988	1,108,277
Total liabilities and stockholders’ equity	$ 1,755,582	$ 1,869,778

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 125,018	$ 109,952
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	250,000,000	250,000,000
Common stock, shares issued (in shares)	126,562,037	124,107,500
Common stock, shares outstanding (in shares)	126,562,037	124,107,500

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Total net revenue	$ 128,782	$ 121,340	$ 371,023	$ 358,597
COST OF REVENUE	79,889	74,101	239,952	216,794
GROSS PROFIT	48,893	47,239	131,071	141,803
Operating expenses:
General and administrative	64,282	63,839	188,481	158,953
Research and development	7,312	7,409	23,651	13,360
Sales and marketing	16,809	15,704	50,179	46,677
Total operating expenses	88,403	86,952	262,311	218,990
Loss from operations	(39,510)	(39,713)	(131,240)	(77,187)
Interest expense, net	139	1,296	2,366	3,375
Other (income) expense, net	(25)	(89)	212	(431)
Gain on investment in and loan receivable from non-consolidated affiliate, net	0	(17,750)	0	(109,260)
(Loss) income before taxes	(39,624)	(23,170)	(133,818)	29,129
Income tax benefit	(2,772)	(2,822)	(12,255)	(4,283)
NET (LOSS) INCOME	$ (36,852)	$ (20,348)	$ (121,563)	$ 33,412
NET (LOSS) INCOME PER SHARE
Basic (in dollars per share)	$ (0.30)	$ (0.17)	$ (0.98)	$ 0.28
Diluted (in dollars per share)	$ (0.30)	$ (0.17)	$ (0.98)	$ 0.28
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic (in shares)	124,425	122,559	124,055	119,087
Diluted (in shares)	124,425	122,559	124,055	121,356
Clinical Services
Total net revenue	$ 106,162	$ 102,227	$ 310,588	$ 300,119
COST OF REVENUE	65,261	59,560	197,563	178,358
GROSS PROFIT	40,901	42,667	113,025	121,761
Pharma Services
Total net revenue	22,620	19,113	60,435	58,478
COST OF REVENUE	14,628	14,541	42,389	38,436
GROSS PROFIT	$ 7,992	$ 4,572	$ 18,046	$ 20,042

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE (LOSS) INCOME - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement of Comprehensive Income [Abstract]
NET (LOSS) INCOME	$ (36,852)	$ (20,348)	$ (121,563)	$ 33,412
OTHER COMPREHENSIVE LOSS:
Net unrealized loss on marketable securities, net of tax	(1,048)	(57)	(4,466)	(400)
Total other comprehensive loss, net of tax	(1,048)	(57)	(4,466)	(400)
COMPREHENSIVE (LOSS) INCOME	$ (37,900)	$ (20,405)	$ (126,029)	$ 33,012

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Cumulative-effect adjustment from change in accounting principle	Common Stock	Additional Paid-In Capital	Additional Paid-In Capital Cumulative-effect adjustment from change in accounting principle	Accumulated Other Comprehensive Loss	Accumulated Deficit	Accumulated Deficit Cumulative-effect adjustment from change in accounting principle
Beginning balance (in shares) at Dec. 31, 2020			112,075,474
Beginning balance at Dec. 31, 2020	$ 694,294	$ (22,575)	$ 112	$ 701,357	$ (23,271)	$ 10	$ (7,185)	$ 696
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Premiums paid for capped call confirmations	(29,291)			(29,291)
Common stock issuance ESPP Plan (in shares)			23,917
Common stock issuance ESPP Plan	1,024			1,024
Issuance of restricted stock, net of forfeitures (in shares)			83,220
Issuance of restricted stock, net of forfeitures	(614)			(614)
Issuance of common stock for stock options (in shares)			260,167
Issuance of common stock for stock options	2,239			2,239
Issuance of common stock - public offering, net of underwriting discounts & private placement, net of private placement fees (in shares)			4,693,876
Issuance of common stock - public offering, net of underwriting discounts & private placement, net of private placement fees	218,500		$ 5	218,495
Stock issuance fees and expenses	(242)			(242)
ESPP expense	241			241
Stock-based compensation expense - options and restricted stock	2,412			2,412
Net unrealized loss on marketable securities, net of tax	(160)					(160)
Net (loss) income	(22,114)						(22,114)
Ending balance (in shares) at Mar. 31, 2021			117,136,654
Ending balance at Mar. 31, 2021	843,714		$ 117	872,350		(150)	(28,603)
Beginning balance (in shares) at Dec. 31, 2020			112,075,474
Beginning balance at Dec. 31, 2020	694,294	$ (22,575)	$ 112	701,357	$ (23,271)	10	(7,185)	$ 696
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net unrealized loss on marketable securities, net of tax	(400)
Net (loss) income	33,412
Ending balance (in shares) at Sep. 30, 2021			123,217,010
Ending balance at Sep. 30, 2021	1,137,245		$ 123	1,110,590		(390)	26,922
Beginning balance (in shares) at Mar. 31, 2021			117,136,654
Beginning balance at Mar. 31, 2021	843,714		$ 117	872,350		(150)	(28,603)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			31,839
Common stock issuance ESPP Plan	1,245			1,245
Issuance of restricted stock, net of forfeitures (in shares)			146,392
Issuance of restricted stock, net of forfeitures	(163)			(163)
Issuance of common stock for stock options (in shares)			354,310
Issuance of common stock for stock options	4,430		$ 1	4,429
Issuance of common stock - public offering, net of underwriting discounts & private placement, net of private placement fees (in shares)			4,444,445
Issuance of common stock - public offering, net of underwriting discounts & private placement, net of private placement fees	189,863		$ 4	189,859
Issuance of common stock for acquisition (in shares)			597,712
Issuance of common stock for acquisition	29,175		$ 1	29,174
Stock issuance fees and expenses	(102)			(102)
ESPP expense	298			298
Stock-based compensation expense - options and restricted stock	4,208			4,208
Net unrealized loss on marketable securities, net of tax	(183)					(183)
Net (loss) income	75,873						75,873
Ending balance (in shares) at Jun. 30, 2021			122,711,352
Ending balance at Jun. 30, 2021	1,148,358		$ 123	1,101,298		(333)	47,270
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			27,210
Common stock issuance ESPP Plan	1,020			1,020
Issuance of restricted stock, net of forfeitures (in shares)			160,971
Issuance of restricted stock, net of forfeitures	(304)			(304)
Issuance of common stock for stock options (in shares)			317,477
Issuance of common stock for stock options	3,374		$ 0	3,374
Stock issuance fees and expenses	(35)			(35)
ESPP expense	236			236
Stock-based compensation expense - options and restricted stock	5,001			5,001
Net unrealized loss on marketable securities, net of tax	(57)					(57)
Net (loss) income	(20,348)						(20,348)
Ending balance (in shares) at Sep. 30, 2021			123,217,010
Ending balance at Sep. 30, 2021	1,137,245		$ 123	1,110,590		(390)	26,922
Beginning balance (in shares) at Dec. 31, 2021			124,107,500
Beginning balance at Dec. 31, 2021	1,108,277		$ 124	1,123,628		(638)	(14,837)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			47,853
Common stock issuance ESPP Plan	971			971
Issuance of restricted stock, net of forfeitures (in shares)			100,253
Issuance of restricted stock, net of forfeitures	(1,049)			(1,049)
Issuance of common stock for stock options (in shares)			466,609
Issuance of common stock for stock options	6,480		$ 1	6,479
ESPP expense	249			249
Stock-based compensation expense - options and restricted stock	11,855			11,855
Net unrealized loss on marketable securities, net of tax	(2,371)					(2,371)
Net (loss) income	(49,408)						(49,408)
Ending balance (in shares) at Mar. 31, 2022			124,722,215
Ending balance at Mar. 31, 2022	1,075,004		$ 125	1,142,133		(3,009)	(64,245)
Beginning balance (in shares) at Dec. 31, 2021			124,107,500
Beginning balance at Dec. 31, 2021	$ 1,108,277		$ 124	1,123,628		(638)	(14,837)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for stock options (in shares)	804,555
Net unrealized loss on marketable securities, net of tax	$ (4,466)
Net (loss) income	(121,563)
Ending balance (in shares) at Sep. 30, 2022			126,562,037
Ending balance at Sep. 30, 2022	1,012,988		$ 127	1,154,365		(5,104)	(136,400)
Beginning balance (in shares) at Mar. 31, 2022			124,722,215
Beginning balance at Mar. 31, 2022	1,075,004		$ 125	1,142,133		(3,009)	(64,245)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			89,374
Common stock issuance ESPP Plan	807			807
Issuance of restricted stock, net of forfeitures (in shares)			773,010
Issuance of restricted stock, net of forfeitures	(310)		$ 1	(311)
Issuance of common stock for stock options (in shares)			94,974
Issuance of common stock for stock options	743			743
ESPP expense	293			293
Stock-based compensation expense - options and restricted stock	3,332			3,332
Net unrealized loss on marketable securities, net of tax	(1,047)					(1,047)
Net (loss) income	(35,303)						(35,303)
Ending balance (in shares) at Jun. 30, 2022			125,679,573
Ending balance at Jun. 30, 2022	1,043,519		$ 126	1,146,997		(4,056)	(99,548)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			150,585
Common stock issuance ESPP Plan	1,133			1,133
Issuance of restricted stock, net of forfeitures (in shares)			493,907
Issuance of restricted stock, net of forfeitures	(5)		$ 1	(6)
Issuance of common stock for stock options (in shares)			237,972
Issuance of common stock for stock options	1,961			1,961
ESPP expense	257			257
Stock-based compensation expense - options and restricted stock	4,023			4,023
Net unrealized loss on marketable securities, net of tax	(1,048)					(1,048)
Net (loss) income	(36,852)						(36,852)
Ending balance (in shares) at Sep. 30, 2022			126,562,037
Ending balance at Sep. 30, 2022	$ 1,012,988		$ 127	$ 1,154,365		$ (5,104)	$ (136,400)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
CASH FLOWS FROM OPERATING ACTIVITIES
Net (loss) income	$ (121,563)	$ 33,412
Adjustments to reconcile net (loss) income to net cash used in operating activities:
Depreciation	25,894	21,807
Amortization of intangibles	25,470	14,683
Non-cash stock-based compensation	20,009	12,396
Non-cash operating lease expense	7,375	6,167
Amortization of convertible debt discount	1,989	1,904
Amortization of debt issue costs	136	133
Gain on investment in and loan receivable from non-consolidated affiliate, net	0	(109,260)
Interest receivable on loan receivable from non-consolidated affiliate	0	(391)
Loss on disposal of assets, net	3,066	166
Gain on sale of assets held for sale	(2,048)	0
Write-off of COVID-19 PCR testing inventory and equipment	0	6,061
Other adjustments	1,428	1,222
Changes in assets and liabilities, net
Accounts receivable, net	136	2,475
Inventories	(403)	3,196
Prepaid lease asset	0	(4,435)
Prepaid and other assets	(3,605)	(11,796)
Accounts payable, operating lease liabilities, deferred taxes, accrued and other liabilities	(20,192)	15,313
Net cash used in operating activities	(62,308)	(6,947)
CASH FLOWS FROM INVESTING ACTIVITIES
Purchases of marketable securities	(73,973)	(180,961)
Proceeds from sales and maturities of marketable securities	89,812	44,736
Purchases of property and equipment	(26,357)	(52,155)
Proceeds from assets held for sale	12,098	0
Business acquisitions, net of cash acquired	0	(419,404)
Loan receivable from non-consolidated affiliate	0	(15,000)
Net cash provided by (used in) investing activities	1,580	(622,784)
CASH FLOWS FROM FINANCING ACTIVITIES
Repayment of equipment financing obligations	(706)	(2,537)
Issuance of common stock, net	10,733	12,110
Proceeds from issuance of convertible debt, net of issuance costs	0	334,410
Premiums paid for capped call confirmations	0	(29,291)
Proceeds from equity offering, net of issuance costs	0	408,133
Net cash provided by financing activities	10,027	722,825
Net change in cash, cash equivalents and restricted cash	(50,701)	93,094
Cash, cash equivalents and restricted cash, beginning of period	316,827	250,632
Cash, cash equivalents and restricted cash, end of period	266,126	343,726
Reconciliation of cash, cash equivalents and restricted cash to the Consolidated Balance Sheets:
Cash and cash equivalents	266,126	340,565
Restricted cash, non-current	0	3,161
Total cash, cash equivalents and restricted cash	266,126	343,726
Supplemental disclosure of cash flow information:
Interest paid	2,145	1,792
Income taxes paid, net	155	113
Supplemental disclosure of non-cash investing and financing information:
Fair value of common stock issued to fund business acquisition	0	29,174
Purchases of property and equipment included in accounts payable	$ 1,144	$ 2,184

Nature of the Business

Nature of the Business	9 Months Ended
	Sep. 30, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of the Business	Nature of the Business Nature of the Business NeoGenomics, Inc., a Nevada corporation (the “Company,” or “NeoGenomics”), and its subsidiaries, operate as a certified, high complexity clinical laboratory in accordance with the federal government’s CLIA, as amended, and is dedicated to the delivery of clinical diagnostic services to pathologists, oncologists, urologists, hospitals, and other laboratories as well as providing clinical trial services to pharmaceutical firms. COVID-19 Pandemic Update The impact from the COVID-19 pandemic, including recent COVID-19 variants, and the related disruptions had a significant adverse impact on the Company’s results of operations, volume growth rates and test volumes in 2020, 2021, and in the first three quarters of 2022. The full extent to which the COVID-19 outbreak will impact the Company’s business, results of operations, financial condition, and cash flows will depend on future developments that are highly uncertain and cannot be accurately predicted, including new information that may emerge concerning COVID-19 and the actions to contain it or treat its impact and the economic impact on local, regional, national, and international markets. As the COVID-19 pandemic continues, the Company’s results of operations, financial condition, and cash flows may continue to be materially adversely affected, particularly if the pandemic continues to persist for a significant amount of time. The Company anticipates that the cash on hand, marketable securities, and expected cash collections are sufficient to fund near-term capital and operating needs for at least the next 12 months. At the end of the first quarter 2021, due to the broad roll-out of the COVID-19 vaccine and a sharp decline in COVID-19 polymerase chain reaction (“PCR”) testing demand, the Company made the decision to exit COVID-19 PCR testing and the Company recorded a $6.1 million expense related to the exit from COVID-19 PCR testing. This amount consisted of write-offs of $5.3 million for all remaining COVID-19 PCR testing inventory recorded to cost of revenue and $0.8 million for all remaining COVID-19 PCR testing laboratory equipment recorded to general and administrative expenses on the Consolidated Statements of Operations for the nine months ended September 30, 2021 . There were no COVID-19 PCR testing laboratory equipment or COVID-19 PCR testing inventory write-offs recorded for the three months ended September 30, 2021 and the three and nine months ended September 30, 2022. Coronavirus Aid, Relief and Economic Security Act The Federal government passed legislation that the President of the United States signed into law on March 27, 2020, known as the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). The CARES Act permits the deferral of payment of the employer portion of social security taxes between March 27, 2020 and December 31, 2020. Fifty percent of the deferred amount was due on December 31, 2021 and the remaining 50% is due on December 31, 2022. As of September 30, 2022 and December 31, 2021, the total accrued deferred social security taxes related to the CARES Act was $3.0 million. This amount was recorded in accrued expenses and other liabilities on the Consolidated Balance Sheets.

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
Accounting Changes and Error Corrections [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies Basis of Presentation The accompanying interim Consolidated Financial Statements are unaudited and have been prepared in accordance with GAAP for interim financial information. All intercompany transactions and balances have been eliminated in the accompanying Consolidated Financial Statements. The accounting policies of the Company are the same as those set forth in Note 2. Summary of Significant Accounting Policies, to the audited Consolidated Financial Statements contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021, except for new accounting standards discussed under Recent Accounting Pronouncements. Unaudited Interim Financial Information Certain information and footnote disclosures normally included in the Company’s annual audited Consolidated Financial Statements and accompanying notes have been condensed or omitted in these accompanying interim Consolidated Financial Statements and footnotes. Accordingly, the accompanying interim unaudited Consolidated Financial Statements included herein should be read in conjunction with the audited Consolidated Financial Statements and accompanying notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021. The results of operations presented in this Quarterly Report on Form 10-Q are not necessarily indicative of the results of operations that may be expected for any future periods. In the opinion of management, these unaudited Consolidated Financial Statements include all adjustments and accruals, consisting only of normal, recurring adjustments that are necessary for a fair statement of the results of all interim periods reported herein. Use of Estimates The Company prepares its Consolidated Financial Statements in conformity with GAAP. These principles require management to make estimates, judgments and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses, together with amounts disclosed in the related notes to the Consolidated Financial Statements. Actual results and outcomes may differ from management’s estimates, judgments and assumptions. Significant estimates, judgments and assumptions used in these Consolidated Financial Statements include, but are not limited, to those related to revenues, accounts receivable and related allowances, contingencies, useful lives and recovery of long-term assets and intangible assets, income taxes and valuation allowances, stock-based compensation, business combinations, and impairment analysis of goodwill. These estimates, judgments, and assumptions are reviewed periodically and the effects of material revisions in estimates are reflected on the Consolidated Financial Statements prospectively from the date of the change in estimate. Assets Held for Sale Assets to be disposed of by sale are reclassified as held for sale if their carrying amounts are expected to be recovered through a sale transaction rather than through continuing use and when the Company commits to a plan to sell the assets. Assets classified as held for sale are measured at the lower of their carrying value or fair value less selling costs. Such assets are classified within current assets if there is reasonable certainty that the sale and collection of consideration will take place within one year. Upon reclassification as held for sale, long-lived assets are no longer depreciated or amortized and a measurement for impairment is performed to determine if there is an excess of carrying value over fair value less costs to sell. Any remeasurement is reported as an adjustment to the carrying value of the assets. Subsequent changes to estimated fair value less the selling costs will impact the measurement of assets held for sale if the fair value is determined to be less than the carrying value of the assets. The Company owned 43,560 square feet of its Carlsbad, California facility. During the third quarter of 2021, the Company committed to selling this property and the associated land and concluded that these assets met the held for sale criteria. As of December 31, 2021, $10.1 million was recorded as assets held for sale within current assets on the Consolidated Balance Sheets for this property and associated land and reflected its carrying value which was lower than its fair value less costs to sell. The Company sold this property and associated land for proceeds of $12.1 million, net of closing costs, in the first quarter of 2022. For the nine months ended September 30, 2022, a net gain on the sale of this property and associated land of $2.0 million is included in general and administrative expenses on the Consolidated Statements of Operations. Goodwill The Company evaluates goodwill on an annual basis in the fourth quarter or more frequently if management believes indicators of impairment exist. Such indicators could include, but are not limited to, (1) a significant adverse change in legal factors or in business climate, (2) unanticipated competition, or (3) an adverse action or assessment by a regulator. The Company first assesses qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount, including goodwill. If management concludes that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, management performs a quantitative goodwill impairment test. The quantitative analysis is performed by comparing the fair value of the reporting unit to its carrying value. If the carrying value is greater than the estimate of fair value, an impairment loss will be recognized for the amount in which the carrying amount exceeds the reporting unit’s fair value. The Company estimates the fair values of its reporting units using a combination of the income, or discounted cash flows approach and the market approach, which utilizes comparable companies’ data. At June 30, 2022, the Company performed a qualitative assessment to determine whether it was more likely than not that the fair values of its reporting units were less than their carrying values. Such qualitative factors included macroeconomic conditions, industry and market considerations, cost factors, overall financial performance and other relevant events. As a result of the qualitative assessment, the Company determined that there were indicators that it was more likely than not that the fair values of its reporting units were less than their carrying values. Accordingly, the Company performed a quantitative analysis and determined the reporting units’ fair values exceeded the reporting units’ carrying values and there was no impairment of the recorded goodwill as of June 30, 2022. General and Administrative Expenses General and administrative expenses consist of payroll and payroll related costs for the Company’s billing, finance, human resources, information technology, and other administrative personnel as well as stock-based compensation. The Company also includes professional services, facilities expense, IT infrastructure costs, gains or losses on disposals of assets, depreciation, amortization, and other administrative-related costs in general and administrative expenses in the Consolidated Statements of Operations. Sales and Marketing Expenses Sales and marketing expenses are primarily attributable to employee-related costs including sales management, sales representatives, sales and marketing consultants, and marketing and customer service personnel in the Clinical Services segment. Advertising costs are expensed at the time they are incurred and were immaterial for the three and nine months ended September 30, 2022 and 2021. Recent Accounting Pronouncements In November 2021, the FASB issued ASU No. 2021-10, Government Assistance (Topic 832), Disclosures by Business Entities about Government Assistance (“ASU 2021-10”). This update requires business entities to disclose information annually about certain government assistance they receive. Such annual disclosure requirements include the nature of the transactions and the related accounting policy used, the line items on the balance sheet and income statement that are affected and the amounts applicable to each financial statement line item and significant terms and conditions of the transactions. ASU 2021-10 is effective for annual periods beginning after December 15, 2021, with early adoption permitted. ASU 2021-10 should be applied either (1) prospectively to all transactions within the scope of the amendments that are reflected in financial statements at the date of initial application and new transactions that are entered into after the date of initial application or (2) retrospectively to those transactions. The Company will adopt this new accounting standard in its Annual Report on Form 10-K for the year ended December 31, 2022 and does not expect the adoption of this standard to have a material impact on its Consolidated Financial Statements. In October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805), Accounting for Contract Assets and Contract Liabilities from Contracts with Customers ( “ ASU 2021-08 ”) . This update amends guidance to require that an entity (acquirer) recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Revenue from Contracts with Customers (Topic 606) . At the acquisition date, an acquirer should account for the related revenue contracts in accordance with Topic 606 as if it had originated the contracts. ASU 2021-08 is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption of the amendments is permitted including adoption in an interim period. If the Company early adopts in an interim period, the Company is required to apply the amendments (1) retrospectively to all business combinations for which the acquisition date occurs on or after the beginning of the fiscal year that includes the interim period of early application and (2) prospectively to all business combinations that occur on or after the date of initial application. The amendments in ASU 2021-08 should be applied prospectively to business combinations occurring on or after the effective date of the amendments. The Company is currently evaluating its adoption date of this standard and the impact of the standard on its Consolidated Financial Statements. In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting ( “ ASU 2020-04 ” ) which provides for temporary optional expedients and exceptions to the current guidance on certain contract modifications and hedging relationships to ease the burdens related to the expected market transition from the London Inter-bank Offered Rate ( “ LIBOR ” ) or other reference rates to alternative reference rates. In January 2021, the FASB issued ASU No. 2021-01 , Reference Rate Reform (Topic 848) ( “ ASU 2021-01 ” ) to clarify that certain optional expedients and exceptions apply to modifications of derivative contracts and certain hedging relationships affected by changes in the interest rates used for discounting cash flows, computing variation margin settlements, and for calculating price alignment interest. ASU 2020-04 was effective beginning on March 12, 2020 and may be applied prospectively to such transactions through December 31, 2022 and ASU 2021-01 was effective beginning on January 7, 2021 and may be applied retrospectively or prospectively to such transactions through December 31, 2022. The Company will evaluate transactions or contract modifications occurring as a result of reference rate reform and determine whether to apply the optional guidance on an ongoing basis. As of September 30, 2022, there was no impact to the Company’s Consolidated Financial Statements related to ASU 2020-04 or ASU 2021-01.

Acquisitions

Acquisitions	9 Months Ended
	Sep. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Acquisitions	Acquisitions Trapelo Health On April 7, 2021 (the “Trapelo Acquisition Date”), the Company completed the acquisition of a 100% ownership interest in Intervention Insights, Inc. d/b/a Trapelo Health (“Trapelo”), an information technology company focused on precision oncology. The purchase price consisted of (i) cash consideration of $35.6 million, which included a net adjustment of $0.6 million for estimated cash on hand of Trapelo and estimated working capital adjustments on the Trapelo Acquisition Date, and (ii) equity consideration of $29.2 million, consisting of 597,712 shares of the Company’s common stock, par value $0.001 per share, valued at $48.81 per share. The Company acquired control of Trapelo on the Trapelo Acquisition Date; therefore, the fair value of the common stock issued as part of consideration was determined on the basis of the closing market price of the Company’s common stock immediately prior to the Trapelo Acquisition Date. The Trapelo acquisition enhances the Company’s ability to provide customers clinical decision support to help answer complex questions related to precision oncology biomarker testing and treatment options as part of the Company’s comprehensive oncology offerings. The acquisition of Trapelo was determined to be a business combination and has been accounted for using the acquisition method. The purchase price and purchase price allocation were based upon management’s best estimates and assumptions and were considered final as of March 31, 2022. The following table summarizes the purchase consideration recorded for the acquisition of Trapelo, the fair value of the net assets acquired and liabilities assumed, and the calculation of goodwill based on the excess of the consideration transferred over the fair value of the net assets acquired and liabilities assumed at the Trapelo Acquisition Date (in thousands, except per share data): Amount Purchase consideration: Shares of common stock issued as consideration 597,712 Per share value of common stock issued as consideration $ 48.81 Fair value of common stock at Trapelo Acquisition Date $ 29,174 Plus: Cash paid at closing 35,591 Total purchase consideration $ 64,765 Allocation of the purchase consideration: Cash $ 713 Other current assets 282 Identifiable intangible asset - marketing assets 549 Identifiable intangible asset - developed technology 19,040 Other long-term assets 268 Total identifiable assets acquired 20,852 Current liabilities (751) Net identifiable assets acquired 20,101 Goodwill 44,664 Total purchase consideration $ 64,765 The identified developed technology and marketing intangible assets are being amortized over ten years and four years, respectively, based on their estimated useful lives. The weighted-average amortization period in total for all classes of intangible assets from the Trapelo acquisition is 9.8 years. The developed technology was valued using the income approach, specifically, the multi-period excess earnings method, which measures the after-tax cash flows attributable to the developed technology. The marketing intangible assets were valued using the income approach, specifically, the relief from royalty method, which measures the cash flow streams attributable to the marketing intangible assets in the form of the avoided royalty payment that would be paid to the owner in return for the rights to use the marketing intangible assets had the intangible assets not been acquired. The values of the identifiable intangible assets represent Level 3 measurements as they were based on unobservable inputs reflecting the Company’s assumptions used in pricing the assets at fair value. These inputs required significant judgments and estimates at the time of the valuation. The goodwill recognized, all of which was assigned to the Clinical Services segment, was primarily attributable to expected synergies of the combined businesses and the acquisition of an assembled workforce knowledgeable of the healthcare and information technology industries. None of the goodwill resulting from the acquisition of Trapelo is expected to be deductible for income tax purposes. The results of operations of Trapelo are included in the Company’s unaudited Consolidated Financial Statements beginning on the Trapelo Acquisition Date. No pro forma information has been included relating to the Trapelo acquisition, as this acquisition was not deemed to be material to the Company’s revenue or net loss on a pro forma basis. Inivata Limited On June 18, 2021 (the “Inivata Acquisition Date”), the Company completed the acquisition of the remaining equity interests in Inivata Limited, a private limited company incorporated in England and Wales (“Inivata”). Inivata is a global, commercial stage, liquid biopsy platform company. The acquisition follows a $25.0 million minority equity investment by the Company in Series C1 Preference Shares (the “Preference Shares” or “previously-held equity interest”) in Inivata in May 2020, at which time the Company also acquired a fixed price option to purchase the remainder of equity interests in Inivata for $390.0 million (the “Purchase Option”). The Company and Inivata also entered into a line of credit agreement in the amount of $15.0 million (the “Line of Credit”) in May 2020. In the first quarter of 2021, prior to the Inivata Acquisition Date, an observable transaction of an identical investment in Inivata Preference Shares occurred which resulted in a remeasurement of the Preference Shares to the value of this observable transaction. The Company recorded a net unrealized loss of $5.0 million on investment in non-consolidated affiliate for this remeasurement for the three months ended March 31, 2021 in other expense (income), net on the Consolidated Statements of Operations. The Inivata acquisition adds liquid biopsy platform technology, including minimal residual disease testing capabilities, to the Company’s comprehensive portfolio of oncology testing solutions. The purchase price consisted of cash consideration of $398.6 million, which included a net adjustment of $8.6 million for estimated cash on hand of Inivata and other adjustments on the Inivata Acquisition Date, and was funded through cash on hand and a private placement of equity. Prior to the acquisition of the remaining equity interests in Inivata, the Company accounted for its previously-held equity interest and the Purchase Option in Inivata as equity securities without a readily determinable fair value. The equity interests were recorded at cost minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer. Therefore, the Company’s acquisition of control of Inivata on the Inivata Acquisition Date was accounted for as a business combination achieved in stages under the acquisition method. Accordingly, the Company used a discounted cash flow to derive a business enterprise value of Inivata in order to determine the acquisition-date fair value of the Company’s previously-held equity interest and Purchase Option in Inivata. To determine the fair value of the previously-held equity interest, the fair value of Inivata’s total equity was allocated to its various classes of equity based on the respective rights and privileges of each class of stock in liquidation. The business enterprise value and a Black-Scholes model were then used to determine the fair value of the remaining equity acquired through the exercise of the Purchase Option. The Purchase Option was recorded at the fair value at the Inivata Acquisition Date based on its settlement value. This resulted in fair values of $64.9 million in Preference Shares and a $74.3 million Purchase Option, immediately prior to the acquisition. On the Inivata Acquisition Date, the $10.3 million outstanding under the Line of Credit extended by the Company to Inivata was effectively settled as part of the acquisition of Inivata at the $15.0 million principal amount and was recorded as part of the consideration transferred in the acquisition. The Company recorded a gain on investment in and loan receivable from non-consolidated affiliate, net, within the Company’s Consolidated Statements of Operations of $109.3 million for the year ended December 31, 2021 for the excess of the acquisition-date fair value of the Company’s previously-held equity interest, Purchase Option, and Line of Credit over their carrying values. The purchase price and purchase price allocation were based upon management’s best estimates and assumptions and were considered final as of June 30, 2022. The following table summarizes the calculation of goodwill based on the excess of the estimated fair value of the consideration transferred including the fair value of the Line of Credit, and the estimated fair value of the previously-held equity interest and Purchase Option, over the estimated fair value of the net assets acquired and liabilities assumed at the Inivata Acquisition Date and includes measurement period adjustments recorded during 2021 (in thousands): June 18, 2021 Measurement Period Adjustments Adjustment June 18, 2021 Fair value of business combination: Cash paid at closing $ 398,594 $ — $ — $ 398,594 Fair value of Line of Credit 15,000 — — 15,000 Fair value of consideration transferred $ 413,594 $ — $ — $ 413,594 Fair value of previously-held equity interest (1) 62,919 1,987 — 64,906 Fair value of Purchase Option (1) 58,537 15,763 — 74,300 Total fair value of business combination $ 535,050 $ 17,750 $ — $ 552,800 Allocation of the fair value business combination: Cash $ 14,068 $ — $ — $ 14,068 Other current assets (2) 5,366 345 — 5,711 Property and equipment 1,753 — — 1,753 Identifiable intangible assets - developed technology (1) 302,982 (11,796) — 291,186 Identifiable intangible assets - trademarks (1) 31,700 (226) — 31,474 Identifiable intangible asset - trade name (1) 2,322 253 — 2,575 Other long-term assets 6,240 — — 6,240 Total identifiable assets acquired 364,431 (11,424) — 353,007 Current liabilities (4,241) (1,650) — (5,891) Deferred income tax liabilities (3)(4) (64,680) 3,686 4,349 (56,645) Other long-term liabilities (4,690) — — (4,690) Net identifiable assets acquired 290,820 (9,388) 4,349 285,781 Goodwill (4) 244,230 27,138 (4,349) 267,019 Total fair value of business combination $ 535,050 $ 17,750 $ — $ 552,800 (1) Measurement period adjustment primarily relates to a change in estimated taxes based on jurisdictions in which forecasted profits are expected to be generated. (2) Measurement period adjustment relates to the recognition of a credit which Inivata is entitled to claim for certain research and development expenditures (3) Measurement period adjustment relates to a change in estimated deferred income tax liabilities as a result of the reduction in the amounts for intangibles assets and related future amortization. (4) During the third quarter of 2022, we recorded a $4.3 million decrease to goodwill and corresponding decrease to deferred income tax liabilities, net, on the Consolidated Balance Sheets to correct an immaterial error related to a prior period. The error was not material to any previously reported annual or interim consolidated financial statements. The identified developed technology intangible assets and the trademark intangible assets are both being amortized over fifteen years, and the trade name intangible asset is being amortized over five years, based on their estimated useful lives. The weighted-average amortization period in total for all classes of intangible assets from the Inivata acquisition is 14.9 years. The developed technology was valued using the income approach, specifically, the multi-period excess earnings method, which measures the after-tax cash flows attributable to the developed technology. The trademarks and trade name assets were valued using the income approach, specifically, the relief from royalty method, which measures the cash flow streams attributable to the trademarks and trade name assets in the form of the avoided royalty payment that would be paid to the owner in return for the rights to use the trademarks and trade name assets had the assets not been acquired. The values of the identifiable intangible assets represent Level 3 measurements as they were based on unobservable inputs reflecting the Company’s assumptions used in pricing the assets at fair value. These inputs required significant judgments and estimates at the time of the valuation. The goodwill recognized, of which $234.6 million and $32.4 million was assigned to the Clinical Services and Pharma Services segments, respectively, was primarily attributable to expected synergies of the combined businesses and the acquisition of an assembled workforce knowledgeable of liquid biopsy technology for oncology testing. The recording of amortizable intangibles has given rise to a deferred tax liability upon the acquisition of Inivata which increased goodwill by $56.6 million. None of the goodwill resulting from the acquisition of Inivata is expected to be deductible for income tax purposes. The following unaudited pro forma information has been provided for illustrative purposes only and is not necessarily indicative of results that would have occurred had the acquisition of Inivata occurred on January 1, 2020, nor are they necessarily indicative of future results (in thousands): Three Months Ended Nine Months Ended (unaudited) (unaudited) Net revenue $ 121,340 $ 358,499 Net loss $ (37,017) $ (88,134) These unaudited pro forma results represent the combined results of operations of the Company and Inivata, on an unaudited pro forma basis, for the period in which the acquisition of Inivata occurred and the prior reporting period as though the companies had been combined as of the beginning of the earliest period presented. Therefore, the unaudited pro forma consolidated results have been prepared by adjusting the Company’s historical results to include the acquisition of Inivata as if it occurred on January 1, 2020. These unaudited pro forma consolidated historical results exclude, $17.8 million of measurement period adjustments recorded in the three months ended September 30, 2021 and $109.3 million of gain on investment in and loan receivable from non-consolidated affiliate, net, recorded in the nine months ended September 30, 2021 .

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value must maximize the use of observable inputs and minimize the use of unobservable inputs. A fair value hierarchy has been established based on three levels of inputs, of which the first two are considered observable and the last unobservable. Level 1: Quoted prices in active markets for identical assets or liabilities. These are typically obtained from real-time quotes for transactions in active exchange markets involving identical assets. Level 2: Inputs, other than quoted prices included within Level 1, which are observable for the asset or liability, either directly or indirectly. These are typically obtained from readily-available pricing sources for comparable instruments. Level 3: Unobservable inputs, where there is little or no market activity for the asset or liability. These inputs reflect the reporting entity’s own assumptions of the data that market participants would use in pricing the asset or liability, based on the best information available in the circumstances. Assets and Liabilities that are Measured at Fair Value on a Recurring Basis The Company measures certain financial assets at fair value on a recurring basis, including its marketable securities and certain cash equivalents. The Company considers all securities available-for-sale, including those with maturity dates beyond 12 months, and therefore these securities are classified within current assets on the Consolidated Balance Sheets as they are available to support current operational liquidity needs. The money market accounts are valued based on quoted market prices in active markets. The marketable securities are generally valued based on other observable inputs for those securities (including market corroborated pricing or other models that utilize observable inputs such as interest rates and yield curves) based on information provided by independent third-party pricing entities, except for U.S. Treasury securities which are valued based on quoted market prices in active markets. The following tables set forth the amortized cost, gross unrealized gains, gross unrealized losses and fair values of the Company’s marketable securities accounted for as available-for-sale securities as of September 30, 2022 and December 31, 2021. September 30, 2022 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: U.S. Treasury securities $ 52,826 $ — $ (889) $ 51,937 Yankee bonds 8,373 — (141) 8,232 Agency bonds 8,890 — (147) 8,743 Municipal bonds 12,877 — (1,119) 11,758 Commercial paper 6,974 — (29) 6,945 Asset-backed securities 30,117 — (510) 29,607 Corporate bonds 62,725 — (2,533) 60,192 Total $ 182,782 $ — $ (5,368) $ 177,414 December 31, 2021 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: U.S. Treasury securities $ 52,791 $ 11 $ (138) $ 52,664 Yankee bonds 6,175 1 (16) 6,160 Agency bonds 17,546 — (16) 17,530 Municipal bonds 12,440 — (211) 12,229 Commercial paper 17,694 — (4) 17,690 Asset-backed securities 27,620 1 (86) 27,535 Corporate bonds 65,198 9 (452) 64,755 Total $ 199,464 $ 22 $ (923) $ 198,563 The Company had $0.7 million and $0.6 million of accrued interest receivable at September 30, 2022 and December 31, 2021, respectively, included in other current assets on its Consolidated Balance Sheets related to its marketable securities. Realized gains or losses on marketable securities for the three and nine months ended September 30, 2022 and September 30, 2021 were immaterial. The following tables set forth the fair value of available-for-sale marketable securities by contractual maturity at September 30, 2022 and December 31, 2021. September 30, 2022 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: U.S. Treasury securities $ 36,102 $ 15,835 $ — $ 51,937 Yankee bonds 5,704 2,528 — 8,232 Agency bonds 6,419 2,324 — 8,743 Municipal bonds — 11,758 — 11,758 Commercial paper 6,945 — — 6,945 Asset-backed securities 25,052 4,555 — 29,607 Corporate bonds 31,945 28,247 — 60,192 Total $ 112,167 $ 65,247 $ — $ 177,414 December 31, 2021 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: U.S. Treasury securities $ 22,550 $ 30,114 $ — $ 52,664 Yankee bonds 4,150 2,010 — 6,160 Agency bonds 14,041 3,489 — 17,530 Municipal bonds — 12,229 — 12,229 Commercial paper 17,690 — — 17,690 Asset-backed securities 20,868 6,667 — 27,535 Corporate bonds 25,412 39,343 — 64,755 Total $ 104,711 $ 93,852 $ — $ 198,563 The following tables set forth the Company’s cash equivalents and marketable securities accounted for as available-for-sale securities that were measured at fair value on a recurring basis based on the fair value hierarchy as of September 30, 2022 and December 31, 2021. September 30, 2022 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 197,901 $ — $ — $ 197,901 Commercial paper — 35,899 — 35,899 Marketable securities: U.S. Treasury securities 51,937 — — 51,937 Yankee bonds 8,232 — — 8,232 Agency bonds 8,743 — — 8,743 Municipal bonds 11,758 — — 11,758 Commercial paper — 6,945 — 6,945 Asset-backed securities — 29,607 — 29,607 Corporate bonds — 60,192 — 60,192 Total $ 278,571 $ 132,643 $ — $ 411,214 December 31, 2021 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 254,157 $ — $ — $ 254,157 Commercial paper — 22,491 — 22,491 Marketable securities: U.S. Treasury securities 52,664 — — 52,664 Yankee bonds 6,160 — — 6,160 Agency bonds 17,530 — — 17,530 Municipal bonds 12,229 — — 12,229 Commercial paper — 17,690 — 17,690 Asset-backed securities — 27,535 — 27,535 Corporate bonds — 64,755 — 64,755 Total $ 342,740 $ 132,471 $ — $ 475,211 There were no transfers of financial assets or liabilities into or out of Level 1, Level 2, or Level 3 for the three and nine months ended September 30, 2022 and September 30, 2021. Assets and Liabilities that are Measured at Fair Value on a Nonrecurring Basis The carrying value of cash and cash equivalents, accounts receivable, net, accounts payable, accrued expenses and other liabilities, and other current assets and liabilities, are considered reasonable estimates of their respective fair values at September 30, 2022 and December 31, 2021 due to their short-term nature. The Company also measures certain non-financial assets at fair value on a nonrecurring basis, primarily intangible assets, goodwill, and long-lived assets in connection with periodic evaluations for potential impairment. The Company estimates the fair value of these assets using primarily unobservable inputs and, as such, these are considered Level 3 fair value measurements.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets The following table summarizes the carrying amounts of goodwill by segment at September 30, 2022 and December 31, 2021 (in thousands): Clinical Services Pharma Services Total Balance at December 31, 2021 $ 462,603 $ 64,512 $ 527,115 Adjustment (1) (3,821) (528) (4,349) Balance at September 30, 2022 $ 458,782 $ 63,984 $ 522,766 (1) During the third quarter of 2022, we recorded a $4.3 million decrease to goodwill and corresponding decrease to deferred income tax liabilities, net, on the Consolidated Balance Sheets to correct an immaterial error related to a prior period. The error was not material to any previously reported annual or interim consolidated financial statements. Intangible assets consisted of the following (in thousands): September 30, 2022 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 53,172 $ 89,929 Developed Technology 10 - 15 310,226 27,787 282,439 Marketing Assets 4 549 204 345 Trademarks 15 31,473 2,699 28,774 Trade Name 5 2,584 670 1,914 Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 84,532 $ 416,848 December 31, 2021 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 45,756 $ 97,345 Developed Technology 10 - 15 310,226 11,798 298,428 Marketing Assets 4 549 100 449 Trademarks 15 31,473 1,125 30,348 Trade Name 5 2,584 276 2,308 Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 59,055 $ 442,325 The Company records amortization expense within cost of revenue and general and administrative expense on the Consolidated Statement of Operations. The following table summarizes the amortization expense for the three and nine months ended September 30, 2022 and 2021 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Amortization of intangibles included in cost of revenue $ 4,853 $ 4,825 $ 14,559 $ 5,554 Amortization of intangibles included in general and administrative expenses 3,637 3,649 10,911 9,129 Total amortization of intangibles $ 8,490 $ 8,474 $ 25,470 $ 14,683 The estimated amortization expense related to amortizable intangible assets for each of the following periods as of September 30, 2022 is as follows (in thousands): Remainder of 2022 $ 8,490 2023 33,962 2024 33,961 2025 33,858 2026 33,547 Thereafter 259,583 Total $ 403,401

Debt

Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Debt	Debt 2028 Convertible Senior Notes On January 11, 2021, the Company completed the sale of $345.0 million of Convertible Senior Notes with a stated interest rate of 0.25% and a maturity date of January 15, 2028 (the “2028 Convertible Notes”), unless earlier converted, redeemed, or repurchased. The last reported sales price of the Company’s common stock was not greater than or equal to 130.0% of the conversion price of the 2028 Convertible Notes on at least 20 of the last 30 consecutive trading days of the quarter ended June 30, 2022. Based on the terms of the 2028 Convertible Notes, the holders could not have converted all or a portion of their 2028 Convertible Notes in the third quarter of 2022. The last reported sales price of the Company’s common stock was not greater than or equal to 130.0% of the conversion price of the 2028 Convertible Notes on at least 20 of the last 30 consecutive trading days of the quarter ended September 30, 2022. Based on the terms of the 2028 Convertible Notes, the holders cannot convert all or a portion of their 2028 Convertible Notes in the fourth quarter of 2022. The value of the 2028 Convertible Notes, if-converted, does not exceed the principal amount based on a closing stock price of $8.61 on September 30, 2022. The interest expense recognized on the 2028 Convertible Notes includes $0.2 million, $0.4 million and $8,500 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the three months ended September 30, 2022. The interest expense recognized on the 2028 Convertible Notes includes $0.7 million, $1.1 million and $25,300 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the nine months ended September 30, 2022. The interest expense recognized on the 2028 Convertible Notes includes $0.2 million, $0.4 million and $8,400 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the three months ended September 30, 2021. The interest expense recognized on the 2028 Convertible Notes includes $0.6 million, $1.0 million and $23,700 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the nine months ended September 30, 2021. The effective interest rate on the 2028 Convertible Notes is 0.70%, which includes the interest on the 2028 Convertible Notes and amortization of the debt discount and debt issuance costs. The 2028 Convertible Notes bear interest at a rate of 0.25% per annum, payable semi-annually in arrears on January 15 and July 15 of each year, beginning on July 15, 2021. At September 30, 2022, the estimated fair values (Level 2) of the 0.25% Convertible Senior Notes due 2028 was $217.4 million. At December 31, 2021, the estimated fair value (Level 2) of the 0.25% Convertible Senior Notes due 2028 was $297.6 million. 2025 Convertible Senior Notes On May 4, 2020, the Company completed the sale of $201.3 million of Convertible Senior Notes with a stated interest rate of 1.25% and a maturity date of May 1, 2025 (the “2025 Convertible Notes”), unless earlier converted, redeemed, or repurchased. The last reported sales price of the Company’s common stock was not greater than or equal to 130.0% of the conversion price of the 2025 Convertible Notes on at least 20 of the last 30 consecutive trading days of the quarter ended June 30, 2022. Based on the terms of the 2025 Convertible Notes, the holders could not have converted all or a portion of their 2025 Convertible Notes in the third quarter of 2022. The last reported sales price of the Company’s common stock was not greater than or equal to 130.0% of the conversion price of the 2025 Convertible Notes on at least 20 of the last 30 consecutive trading days of the quarter ended September 30, 2022. Based on the terms of the 2025 Convertible Notes, the holders cannot convert all or a portion of their 2025 Convertible Notes in the fourth quarter of 2022. The value of the 2025 Convertible Notes, if-converted, does not exceed the principal amount based on a closing stock price of $8.61 on September 30, 2022. The interest expense recognized on the 2025 Convertible Notes includes $0.6 million, $0.3 million and $37,200 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the three months ended September 30, 2022. The interest expense recognized on the 2025 Convertible Notes includes $1.9 million, $0.9 million and $0.1 million for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the nine months ended September 30, 2022. The interest expense recognized on the 2025 Convertible Notes includes $0.6 million, $0.3 million and $36,500 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the three months ended September 30, 2021. The interest expense recognized on the 2025 Convertible Notes includes $1.9 million, $0.9 million and $0.1 million for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the nine months ended September 30, 2021. The effective interest rate on the 2025 Convertible Notes is 1.96%, which includes the interest on the 2025 Convertible Notes and amortization of the debt discount and debt issuance costs. The 2025 Convertible Notes bear interest at a rate of 1.25% per annum, payable semi-annually in arrears on May 1 and November 1 of each year, which began on November 1, 2020.

Stock-Based Compensation

Stock-Based Compensation	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Stock-Based Compensation	Stock-Based Compensation The Company recorded approximately $4.3 million and $5.2 million for stock-based compensation in general and administrative expenses on the Consolidated Statements of Operations for the three months ended September 30, 2022 and 2021, respectively, and approximately $20.0 million and $12.4 million for the nine months ended September 30, 2022 and 2021, respectively. Stock Options A summary of the stock option activity under the Company’s plans for the nine months ended September 30, 2022 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2021 2,961,195 $ 25.46 Options granted 3,849,603 $ 14.94 Less: Options exercised 804,555 $ 11.35 Options forfeited 1,758,886 $ 28.75 Options outstanding at September 30, 2022 4,247,357 $ 17.23 Exercisable at September 30, 2022 1,019,075 $ 24.91 The fair value of each stock option award granted during the nine months ended September 30, 2022 was estimated as of the grant date using a Black-Scholes model with the following assumptions: Nine Months Ended Expected term (in years) 3.0 - 5.5 Risk-free interest rate (%) 1.4% - 3.4% Expected volatility (%) 42% - 60% Dividend yield (%) — Weighted average grant date fair value per share $6.51 As of September 30, 2022, there was approximately $14.8 million of unrecognized stock-based compensation expense related to stock options that will be recognized over a weighted-average period of approximately 2.2 years. Restricted Stock Awards A summary of the restricted stock activity under the Company’s plans for the nine months ended September 30, 2022 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2021 851,403 $ 36.00 Granted 2,477,418 $ 14.58 Vested (311,055) $ 36.71 Forfeited (1,022,904) $ 27.10 Nonvested at September 30, 2022 1,994,862 $ 13.84 As of September 30, 2022, there was approximately $19.8 million of unrecognized stock-based compensation expense related to restricted stock that will be recognized over a weighted-average period of approximately 2.2 years. Modification of Stock Option and Restricted Stock Awards In the second quarter of 2022, upon the Chief Legal Officer’s departure from the Company and in accordance with the terms of the Chief Legal Officer’s employment agreement, 41,487 previously granted time-based vesting stock option awards and 76,138 previously granted time-vesting restricted stock awards accelerated vesting. The Company accounted for the effects of the accelerated vesting of these stock awards as a modification, and recognized $2.2 million of incremental stock-based compensation which consisted of $0.3 million and $1.9 million for the acceleration of stock option awards and restricted stock

Revenue Recognition

Revenue Recognition	9 Months Ended
	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Revenue Recognition	Revenue Recognition The Company’s two reportable segments for which it recognizes revenue are (1) Clinical Services and (2) Pharma Services. The Clinical Services segment provides various clinical testing services to community-based pathology practices, oncology practices, hospital pathology labs, reference labs, and academic centers with reimbursement from various payers including client direct billing, commercial insurance, Medicare and other government payers, and patients. The Pharma Services segment supports pharmaceutical firms in their drug development programs by providing testing services and data analytics for clinical trials and research. Clinical Services Revenue The Company’s specialized diagnostic services are performed based on a written test requisition form or electronic equivalent. The performance obligation is satisfied and revenues are recognized once the diagnostic services have been performed and the results have been delivered to the ordering physician. These diagnostic services are billed to various payers, including client direct billing, commercial insurance, Medicare and other government payers, and patients. Revenue is recorded for all payers based on the amount expected to be collected, which considers implicit price concessions. Implicit price concessions represent differences between amounts billed and the estimated consideration the Company expects to receive based on negotiated discounts, historical collection experience and other anticipated adjustments, including anticipated payer denials. Collection of consideration the Company expects to receive typically occurs within 90 to 120 days of billing for commercial insurance, Medicare and other governmental and self-pay payers and within 60 to 90 days of billing for client payers. Pharma Services Revenue The Company’s Pharma Services segment generally enters into contracts with pharmaceutical customers as well as other CROs to provide research and clinical trial services ranging in duration from one month to several years. The Company records revenue on a unit-of-service basis based on number of units completed and the total expected contract value. The total expected contract value is estimated based on historical experience of total contracted units compared to realized units as well as known factors on a specific contract-by-contract basis. Certain contracts include upfront fees, final settlement amounts, and/or billing milestones that may not align with the completion of performance obligations. The value of these upfront fees or final settlement amounts is usually recognized over time based on the number of units completed, which aligns with the progress of the Company towards fulfilling its obligations under the contract. The Company also enters into other contracts, such as validation studies and informatics. Revenue for validation studies for which the sole deliverable may be a final report that is sent to the sponsor(s) at the completion of contracted activities, is recognized at a point in time upon delivery of the final report to the sponsor. Informatics is the sale of de-identified data for which deliverables typically consist of retrospective records or prospective deliveries of data. Informatics revenue is recognized upon delivery of retrospective data or over time for prospective data feeds. Any contracts that contain multiple performance obligations and include both units-of-service and point in time deliverables are accounted for as separate performance obligations and revenue is recognized as previously disclosed. The Company negotiates billing schedules and payment terms on a contract-by-contract basis. While the contract terms generally provide for payments based on a unit-of-service arrangement, the billing schedules, payment terms, and related cash payments may not align with the performance of services and, as such, may not correspond to revenue recognized in any given period. Amounts collected in advance of services being provided are deferred as contract liabilities on the Consolidated Balance Sheets. The associated revenue is recognized and the contract liability is reduced as the contracted services are subsequently performed. Contract assets are established for revenue recognized but not yet billed. These contract assets are reduced once the customer is invoiced and a corresponding receivable is recorded. Additionally, certain costs to obtain contracts, primarily for sales commissions, are capitalized when incurred and amortized over the term of the contract. Amounts capitalized for contracts with an initial contract term of twelve months or less are classified as current assets. All others are classified as non-current assets. Most contracts are terminable by the customers, either immediately or according to advance notice terms specified within the contracts. All contracts require payment of fees to the Company for services rendered through the date of termination and may require payment for subsequent services necessary to conclude the study or close out the contract. The following table summarizes the values of contract assets, capitalized commissions and contract liabilities (in thousands): September 30, 2022 December 31, 2021 Current pharma contract assets (1) $ 2,679 $ 1,738 Long-term pharma contract assets (2) 257 236 Total pharma contract assets $ 2,936 $ 1,974 Current pharma capitalized commissions (1) $ 106 $ 109 Long-term pharma capitalized commissions (2) 1,527 882 Total pharma capitalized commissions $ 1,633 $ 991 Current pharma contract liabilities $ 6,386 $ 5,192 Long-term pharma contract liabilities (3) 1,128 917 Total pharma contract liabilities $ 7,514 $ 6,109 (1) Current pharma contract assets and Current pharma capitalized commissions are classified as other current assets on the Consolidated Balance Sheets. (2) Long-term pharma contract assets and Long-term pharma capitalized commissions are classified as other assets on the Consolidated Balance Sheets. (3) Long-term pharma contract liabilities are classified as other long-term liabilities on the Consolidated Balance Sheets. Revenue recognized for the three and nine months ended September 30, 2022 related to Pharma contract liability balances outstanding at the beginning of the period was $0.7 million and $4.8 million, respectively. Revenue recognized for the three and nine months ended September 30, 2021 related to Pharma contract liability balances outstanding at the beginning of the period was $0.4 million and $4.2 million, respectively. Amortization of capitalized commissions for the three and nine months ended September 30, 2022 was $0.3 million and $0.6 million, respectively. Amortization of capitalized commissions for the three and nine months ended September 30, 2021 was $0.2 million and $0.9 million, respectively. Disaggregation of Revenue The Company considered various factors for both its Clinical Services and Pharma Services segments in determining appropriate levels of homogeneous data for its disaggregation of revenue; including the nature, amount, timing, and uncertainty of revenue and cash flows. Clinical Services categories align with the types of customers due to similarities of billing method, level of reimbursement, and timing of cash receipts. Unbilled amounts are accrued and allocated to payer categories based on historical experience. In future periods actual billings by payer category may differ from accrued amounts. Pharma Services relate to contracts with large pharmaceutical and biotech customers as well as other CROs. Because the nature, timing, and uncertainty of revenue and cash flows are similar and primarily driven by individual contract terms Pharma Services revenue is not further disaggregated. The following table details the disaggregation of revenue for both the Clinical and Pharma Services Segments (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Clinical Services: Client direct billing $ 73,234 $ 64,195 $ 208,123 $ 188,040 Commercial Insurance 17,105 19,539 53,904 58,642 Medicare and Medicaid 15,795 18,295 48,427 52,929 Self-Pay 28 198 134 508 Total Clinical Services $ 106,162 $ 102,227 $ 310,588 $ 300,119 Pharma Services: 22,620 19,113 60,435 58,478 Total Revenue $ 128,782 $ 121,340 $ 371,023 $ 358,597

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes At the end of each interim period, management estimates the annual effective tax rate based on forecasted pre-tax results of the Company’s global operations and applies such rate to its ordinary quarterly earnings to calculate income tax expense related to ordinary income. The tax effects of items significant, unusual and infrequent in nature are discretely calculated and recognized in the period during which they occur. These discrete items often relate to changes in tax laws, excess tax benefits/deficiencies related to share-based compensation or adjustments to previously reported tax expense/benefits. Management assesses the recoverability of its deferred tax assets as of the end of each quarter, weighing available positive and negative evidence, and is required to establish and maintain a valuation allowance for these assets if it is more likely than not that some or all of the deferred income tax assets will not be realized. The weight given to the evidence is commensurate with the extent to which the evidence can be objectively verified. If negative evidence exists, positive evidence is necessary to support a conclusion that a valuation allowance is not needed. A cumulative loss in recent years is a significant piece of negative evidence that is difficult to overcome. Cumulative loss in recent years is commonly defined as a three-year cumulative loss position. As of September 30, 2022, the Company’s U.S. ongoing operations were in a three-year cumulative loss position. Management determined that sufficient objectively verifiable positive evidence did not exist to overcome the negative evidence of the Company’s U.S. cumulative loss position. Accordingly, the Company’s estimated annual effective tax rate applied to the Company’s pre-tax loss for the three and nine months ended September 30, 2022, includes the unfavorable impact of a valuation allowance against the Company’s deferred income tax assets expected to be created in 2022 for additional U.S. net operating loss and tax credit carryforwards.

Net (Loss) Income Per Share

Net (Loss) Income Per Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Net (Loss) Income Per Share	Net (Loss) Income Per Share The Company presents both basic earnings per share (“EPS”) and diluted EPS. Basic EPS excludes potential dilution and is computed by dividing net loss by the weighted-average number of common shares outstanding for the period. Diluted EPS reflects the potential dilution that could occur if stock awards were exercised and if the 2028 Convertible Notes and 2025 Convertible Notes were converted. The potential dilution from stock awards is accounted for using the treasury stock method based on the average market value of the Company’s common stock. The potential dilution from conversion of the 2028 Convertible Notes and 2025 Convertible Notes is accounted for using the if-converted method, which requires that all of the shares of the Company’s common stock issuable upon conversion of the 2028 Convertible Notes and the 2025 Convertible Notes will be included in the calculation of diluted EPS assuming conversion of the 2028 Convertible Notes and the 2025 Convertible Notes at the beginning of the reporting period (or at time of issuance, if later). The following table shows the calculations (in thousands, except net loss per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 NET (LOSS) INCOME $ (36,852) $ (20,348) $ (121,563) $ 33,412 Basic weighted average shares outstanding 124,425 122,559 124,055 119,087 Dilutive effect of stock options — — — 2,077 Dilutive effect of restricted stock awards — — — 192 Dilutive effect of Convertible Notes due 2025 — — — — Dilutive effect of Convertible Notes due 2028 — — — — Diluted weighted average shares outstanding 124,425 122,559 124,055 121,356 Basic net (loss) income per share $ (0.30) $ (0.17) $ (0.98) $ 0.28 Diluted net (loss) income per share $ (0.30) $ (0.17) $ (0.98) $ 0.28 The following potential dilutive shares were excluded from the calculation of diluted net (loss) income per share because their effect would be anti-dilutive (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Stock options 45 1,811 272 — Restricted stock awards 295 201 266 — 2025 Convertible Notes 5,538 5,538 5,538 5,538 2028 Convertible Notes 5,215 5,215 5,215 5,101 In connection with the 2028 Convertible Notes offering, on January 11, 2021, the Company entered into separate, privately negotiated convertible note hedge transactions (collectively, the “Capped Call Transactions”) with option counterparties pursuant to capped call confirmations at a cost of approximately $29.3 million. The potential effect of the Capped Call Transactions were excluded from the calculation of diluted net loss per share in the three and nine months ended September 30, 2022 as the Company’s closing price on September 30, 2022 did not exceed the conversion price of $85.75 per share. The Capped Call Transactions are not reflected in diluted net loss per share as they are anti-dilutive.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments an Contingencies	Commitments and Contingencies Legal Proceeding On January 20, 2021, Natera, Inc. filed a patent infringement complaint against the Company’s newly-acquired subsidiary Inivata Limited and its subsidiary Inivata, Inc. in United States District Court for the district of Delaware, alleging Inivata’s InVisionFirst-Lung™ cancer diagnostic test of infringing two patents. The litigation is presently in the pleadings stage. The Company believes that it has good and substantial defenses to the claims alleged in the suit, but there is no guarantee that the Company will prevail. At the time of filing, the outcome of this matter is not estimable or probable. Regulatory Matter With the assistance of outside counsel, the Company is voluntarily conducting an internal investigation that focuses on the compliance of certain consulting and service agreements with federal healthcare laws and regulations, including those relating to fraud, waste and abuse. Based on this internal investigation, the Company voluntarily notified the Office of Inspector General of the U.S. Department of Health and Human Services (“OIG”) of the Company’s internal investigation in November 2021. The Company’s review of this matter is ongoing. The Company has a reserve of $11.2 million in other long-term liabilities as of September 30, 2022 and December 31, 2021 on the Consolidated Balance Sheets for potential damages and liabilities primarily associated with the federal healthcare program revenue received by the Company in connection with the agreements at issue that were identified during the course of this internal investigation. This reserve reflects management’s best estimate of the minimum probable loss associated with this matter. As a result of the ongoing investigation and interactions with regulatory authorities, the Company may accrue additional reserves for any related potential damages and liabilities arising out of this matter. The Company was notified on June 30, 2022 that the Department of Justice (“DOJ”) will be participating in the investigation of this matter. At this time, the Company is unable to predict the duration, scope, result or related costs associated with any further investigation, including by the OIG, DOJ, or any other governmental authority, or what penalties or remedial actions they may seek. Accordingly, at this time, the Company is unable to estimate a range of possible loss in excess of the amount reserved. Any determination that the Company’s operations or activities are not in compliance with existing laws or regulations, however, could result in the imposition of civil or criminal fines, penalties, disgorgement, restitution, equitable relief, or other losses or conduct restrictions, which could be material to the Company’s financial results or business operations.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2022
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions On May 22, 2020, the Company formed a strategic alliance with Inivata and entered into a Strategic Alliance Agreement and Laboratory Services Agreement whereas Inivata, prior to the Inivata Acquisition Date, would render and perform certain laboratory testing which the Company made available to customers. In connection with this agreement, Inivata provided $0.8 million of testing services to the Company recorded in cost of revenue in the Consolidated Statements of Operations for the nine months ended September 30, 2021 through the Inivata Acquisition Date. On June 18, 2021, the Company completed its acquisition of all remaining equity interest in Inivata by exercising its Purchase Option. Beginning June 18, 2021, Inivata is a wholly-owned consolidated subsidiary of the Company. As of the Inivata Acquisition Date, Inivata’s financial statement activity is being consolidated within the Company’s unaudited Consolidated Financial Statements. For further details on the acquisition of Inivata, please refer to Note 3. Acquisitions. The Company has Pharma Services contracts with CytomX Therapeutics, Inc., an entity with whom a director of the Company, Dr. Alison L. Hannah, was an officer at until September 2022, and the Company’s former Chief Legal Officer, Halley E.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segment Information	Segment Information The Company recognizes revenue under two reportable segments, (1) Clinical Services and (2) Pharma Services. The Clinical Services segment provides various clinical testing services to community-based pathology and oncology practices, hospital pathology labs, and academic centers with reimbursement from various payers including client direct billing, commercial insurance, Medicare and other government payers, and self-pay patients. The Pharma Services segment supports pharmaceutical firms’ drug development programs by assisting with various clinical trials and research as well as providing informatics related services often supporting pharmaceutical commercialization efforts. The financial information reviewed by the Chief Operating Decision Maker (“CODM”) includes revenues, cost of revenue, and gross profit for both reportable segments. Assets are not presented at the segment level as that information is not used by the CODM. The following table summarizes the segment information (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Net revenues: Clinical Services $ 106,162 $ 102,227 $ 310,588 $ 300,119 Pharma Services 22,620 19,113 60,435 58,478 Total revenue 128,782 121,340 371,023 358,597 Cost of revenue: Clinical Services (1) 65,261 59,560 197,563 178,358 Pharma Services (2) 14,628 14,541 42,389 38,436 Total cost of revenue 79,889 74,101 239,952 216,794 Gross Profit: Clinical Services 40,901 42,667 113,025 121,761 Pharma Services 7,992 4,572 18,046 20,042 Total gross profit 48,893 47,239 131,071 141,803 Operating expenses: General and administrative 64,282 63,839 188,481 158,953 Research and development 7,312 7,409 23,651 13,360 Sales and marketing 16,809 15,704 50,179 46,677 Total operating expenses 88,403 86,952 262,311 218,990 Loss from operations (39,510) (39,713) (131,240) (77,187) Interest expense, net 139 1,296 2,366 3,375 Other (income) expense, net (25) (89) 212 (431) Gain on investment in and loan receivable from non-consolidated affiliate, net — (17,750) — (109,260) (Loss) income before taxes (39,624) (23,170) (133,818) 29,129 Income tax benefit (2,772) (2,822) (12,255) (4,283) Net (loss) income $ (36,852) $ (20,348) $ (121,563) $ 33,412 (1) Clinical Services cost of revenue for both the three months ended September 30, 2022 and September 30, 2021 includes $4.3 million of amortization of acquired Inivata developed technology intangible assets. Clinical Services cost of revenue for the nine months ended September 30, 2022 include $12.8 million of amortization of acquired Inivata developed technology intangible assets. Clinical Services cost of revenue for the nine months ended September 30, 2021 include write-offs of $5.3 million for COVID-19 PCR testing inventory and $5.0 million of amortization of acquired Inivata developed technology intangible assets.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
Accounting Changes and Error Corrections [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim Consolidated Financial Statements are unaudited and have been prepared in accordance with GAAP for interim financial information. All intercompany transactions and balances have been eliminated in the accompanying Consolidated Financial Statements. The accounting policies of the Company are the same as those set forth in Note 2. Summary of Significant Accounting Policies, to the audited Consolidated Financial Statements contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021, except for new accounting standards discussed under Recent Accounting Pronouncements.
Use of Estimates	Use of Estimates The Company prepares its Consolidated Financial Statements in conformity with GAAP. These principles require management to make estimates, judgments and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses, together with amounts disclosed in the related notes to the Consolidated Financial Statements. Actual results and outcomes may differ from management’s estimates, judgments and assumptions. Significant estimates, judgments and assumptions used in these Consolidated Financial Statements include, but are not limited, to those related to revenues, accounts receivable and related allowances, contingencies, useful lives and recovery of long-term assets and intangible assets, income taxes and valuation allowances, stock-based compensation, business combinations, and impairment analysis of goodwill. These estimates, judgments, and assumptions are reviewed periodically and the effects of material revisions in estimates are reflected on the Consolidated Financial Statements prospectively from the date of the change in estimate.
Assets Held for Sale	Assets Held for Sale Assets to be disposed of by sale are reclassified as held for sale if their carrying amounts are expected to be recovered through a sale transaction rather than through continuing use and when the Company commits to a plan to sell the assets. Assets classified as held for sale are measured at the lower of their carrying value or fair value less selling costs. Such assets are classified within current assets if there is reasonable certainty that the sale and collection of consideration will take place within one year. Upon reclassification as held for sale, long-lived assets are no longer depreciated or amortized and a measurement for impairment is performed to determine if there is an excess of carrying value over fair value less costs to sell. Any remeasurement is reported as an adjustment to the carrying value of the assets. Subsequent changes to estimated fair value less the selling costs will impact the measurement of assets held for sale if the fair value is determined to be less than the carrying value of the assets.
Goodwill	GoodwillThe Company evaluates goodwill on an annual basis in the fourth quarter or more frequently if management believes indicators of impairment exist. Such indicators could include, but are not limited to, (1) a significant adverse change in legal factors or in business climate, (2) unanticipated competition, or (3) an adverse action or assessment by a regulator. The Company first assesses qualitative factors to determine whether it is more likely than not that the fair value of a reporting unit is less than its carrying amount, including goodwill. If management concludes that it is more likely than not that the fair value of a reporting unit is less than its carrying amount, management performs a quantitative goodwill impairment test. The quantitative analysis is performed by comparing the fair value of the reporting unit to its carrying value. If the carrying value is greater than the estimate of fair value, an impairment loss will be recognized for the amount in which the carrying amount exceeds the reporting unit’s fair value. The Company estimates the fair values of its reporting units using a combination of the income, or discounted cash flows approach and the market approach, which utilizes comparable companies’ data.
General and Administrative Expenses and Sales and Marketing Expenses	General and Administrative Expenses General and administrative expenses consist of payroll and payroll related costs for the Company’s billing, finance, human resources, information technology, and other administrative personnel as well as stock-based compensation. The Company also includes professional services, facilities expense, IT infrastructure costs, gains or losses on disposals of assets, depreciation, amortization, and other administrative-related costs in general and administrative expenses in the Consolidated Statements of Operations. Sales and Marketing Expenses Sales and marketing expenses are primarily attributable to employee-related costs including sales management, sales representatives, sales and marketing consultants, and marketing and customer service personnel in the Clinical Services
Recently Accounting Pronouncements	Recent Accounting Pronouncements In November 2021, the FASB issued ASU No. 2021-10, Government Assistance (Topic 832), Disclosures by Business Entities about Government Assistance (“ASU 2021-10”). This update requires business entities to disclose information annually about certain government assistance they receive. Such annual disclosure requirements include the nature of the transactions and the related accounting policy used, the line items on the balance sheet and income statement that are affected and the amounts applicable to each financial statement line item and significant terms and conditions of the transactions. ASU 2021-10 is effective for annual periods beginning after December 15, 2021, with early adoption permitted. ASU 2021-10 should be applied either (1) prospectively to all transactions within the scope of the amendments that are reflected in financial statements at the date of initial application and new transactions that are entered into after the date of initial application or (2) retrospectively to those transactions. The Company will adopt this new accounting standard in its Annual Report on Form 10-K for the year ended December 31, 2022 and does not expect the adoption of this standard to have a material impact on its Consolidated Financial Statements. In October 2021, the FASB issued ASU No. 2021-08, Business Combinations (Topic 805), Accounting for Contract Assets and Contract Liabilities from Contracts with Customers ( “ ASU 2021-08 ”) . This update amends guidance to require that an entity (acquirer) recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Revenue from Contracts with Customers (Topic 606) . At the acquisition date, an acquirer should account for the related revenue contracts in accordance with Topic 606 as if it had originated the contracts. ASU 2021-08 is effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption of the amendments is permitted including adoption in an interim period. If the Company early adopts in an interim period, the Company is required to apply the amendments (1) retrospectively to all business combinations for which the acquisition date occurs on or after the beginning of the fiscal year that includes the interim period of early application and (2) prospectively to all business combinations that occur on or after the date of initial application. The amendments in ASU 2021-08 should be applied prospectively to business combinations occurring on or after the effective date of the amendments. The Company is currently evaluating its adoption date of this standard and the impact of the standard on its Consolidated Financial Statements. In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting ( “ ASU 2020-04 ” ) which provides for temporary optional expedients and exceptions to the current guidance on certain contract modifications and hedging relationships to ease the burdens related to the expected market transition from the London Inter-bank Offered Rate ( “ LIBOR ” ) or other reference rates to alternative reference rates. In January 2021, the FASB issued ASU No. 2021-01 , Reference Rate Reform (Topic 848) ( “ ASU 2021-01 ” ) to clarify that certain optional expedients and exceptions apply to modifications of derivative contracts and certain hedging relationships affected by changes in the interest rates used for discounting cash flows, computing variation margin settlements, and for calculating price alignment interest. ASU 2020-04 was effective beginning on March 12, 2020 and may be applied prospectively to such transactions through December 31, 2022 and ASU 2021-01 was effective beginning on January 7, 2021 and may be applied retrospectively or prospectively to such transactions through December 31, 2022. The Company will evaluate transactions or contract modifications occurring as a result of reference rate reform and determine whether to apply the optional guidance on an ongoing basis. As of September 30, 2022, there was no impact to the Company’s Consolidated Financial Statements related to ASU 2020-04 or ASU 2021-01.

Acquisitions (Tables)

Acquisitions (Tables)	9 Months Ended
	Sep. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the purchase consideration recorded for the acquisition of Trapelo, the fair value of the net assets acquired and liabilities assumed, and the calculation of goodwill based on the excess of the consideration transferred over the fair value of the net assets acquired and liabilities assumed at the Trapelo Acquisition Date (in thousands, except per share data): Amount Purchase consideration: Shares of common stock issued as consideration 597,712 Per share value of common stock issued as consideration $ 48.81 Fair value of common stock at Trapelo Acquisition Date $ 29,174 Plus: Cash paid at closing 35,591 Total purchase consideration $ 64,765 Allocation of the purchase consideration: Cash $ 713 Other current assets 282 Identifiable intangible asset - marketing assets 549 Identifiable intangible asset - developed technology 19,040 Other long-term assets 268 Total identifiable assets acquired 20,852 Current liabilities (751) Net identifiable assets acquired 20,101 Goodwill 44,664 Total purchase consideration $ 64,765 June 18, 2021 Measurement Period Adjustments Adjustment June 18, 2021 Fair value of business combination: Cash paid at closing $ 398,594 $ — $ — $ 398,594 Fair value of Line of Credit 15,000 — — 15,000 Fair value of consideration transferred $ 413,594 $ — $ — $ 413,594 Fair value of previously-held equity interest (1) 62,919 1,987 — 64,906 Fair value of Purchase Option (1) 58,537 15,763 — 74,300 Total fair value of business combination $ 535,050 $ 17,750 $ — $ 552,800 Allocation of the fair value business combination: Cash $ 14,068 $ — $ — $ 14,068 Other current assets (2) 5,366 345 — 5,711 Property and equipment 1,753 — — 1,753 Identifiable intangible assets - developed technology (1) 302,982 (11,796) — 291,186 Identifiable intangible assets - trademarks (1) 31,700 (226) — 31,474 Identifiable intangible asset - trade name (1) 2,322 253 — 2,575 Other long-term assets 6,240 — — 6,240 Total identifiable assets acquired 364,431 (11,424) — 353,007 Current liabilities (4,241) (1,650) — (5,891) Deferred income tax liabilities (3)(4) (64,680) 3,686 4,349 (56,645) Other long-term liabilities (4,690) — — (4,690) Net identifiable assets acquired 290,820 (9,388) 4,349 285,781 Goodwill (4) 244,230 27,138 (4,349) 267,019 Total fair value of business combination $ 535,050 $ 17,750 $ — $ 552,800 (1) Measurement period adjustment primarily relates to a change in estimated taxes based on jurisdictions in which forecasted profits are expected to be generated. (2) Measurement period adjustment relates to the recognition of a credit which Inivata is entitled to claim for certain research and development expenditures (3) Measurement period adjustment relates to a change in estimated deferred income tax liabilities as a result of the reduction in the amounts for intangibles assets and related future amortization. (4) During the third quarter of 2022, we recorded a $4.3 million decrease to goodwill and corresponding decrease to deferred income tax liabilities, net, on the Consolidated Balance Sheets to correct an immaterial error related to a prior period. The error was not material to any previously reported annual or interim consolidated financial statements.
Schedule of Business Acquisition, Pro Forma Information	The following unaudited pro forma information has been provided for illustrative purposes only and is not necessarily indicative of results that would have occurred had the acquisition of Inivata occurred on January 1, 2020, nor are they necessarily indicative of future results (in thousands): Three Months Ended Nine Months Ended (unaudited) (unaudited) Net revenue $ 121,340 $ 358,499 Net loss $ (37,017) $ (88,134)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets Measured on Recurring and Nonrecurring Basis	The following tables set forth the amortized cost, gross unrealized gains, gross unrealized losses and fair values of the Company’s marketable securities accounted for as available-for-sale securities as of September 30, 2022 and December 31, 2021. September 30, 2022 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: U.S. Treasury securities $ 52,826 $ — $ (889) $ 51,937 Yankee bonds 8,373 — (141) 8,232 Agency bonds 8,890 — (147) 8,743 Municipal bonds 12,877 — (1,119) 11,758 Commercial paper 6,974 — (29) 6,945 Asset-backed securities 30,117 — (510) 29,607 Corporate bonds 62,725 — (2,533) 60,192 Total $ 182,782 $ — $ (5,368) $ 177,414 December 31, 2021 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: U.S. Treasury securities $ 52,791 $ 11 $ (138) $ 52,664 Yankee bonds 6,175 1 (16) 6,160 Agency bonds 17,546 — (16) 17,530 Municipal bonds 12,440 — (211) 12,229 Commercial paper 17,694 — (4) 17,690 Asset-backed securities 27,620 1 (86) 27,535 Corporate bonds 65,198 9 (452) 64,755 Total $ 199,464 $ 22 $ (923) $ 198,563
Schedule of Investments Classified by Contractual Maturity Date	The following tables set forth the fair value of available-for-sale marketable securities by contractual maturity at September 30, 2022 and December 31, 2021. September 30, 2022 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: U.S. Treasury securities $ 36,102 $ 15,835 $ — $ 51,937 Yankee bonds 5,704 2,528 — 8,232 Agency bonds 6,419 2,324 — 8,743 Municipal bonds — 11,758 — 11,758 Commercial paper 6,945 — — 6,945 Asset-backed securities 25,052 4,555 — 29,607 Corporate bonds 31,945 28,247 — 60,192 Total $ 112,167 $ 65,247 $ — $ 177,414 December 31, 2021 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: U.S. Treasury securities $ 22,550 $ 30,114 $ — $ 52,664 Yankee bonds 4,150 2,010 — 6,160 Agency bonds 14,041 3,489 — 17,530 Municipal bonds — 12,229 — 12,229 Commercial paper 17,690 — — 17,690 Asset-backed securities 20,868 6,667 — 27,535 Corporate bonds 25,412 39,343 — 64,755 Total $ 104,711 $ 93,852 $ — $ 198,563
Schedule of Fair Value, Assets Measured on Recurring Basis	The following tables set forth the Company’s cash equivalents and marketable securities accounted for as available-for-sale securities that were measured at fair value on a recurring basis based on the fair value hierarchy as of September 30, 2022 and December 31, 2021. September 30, 2022 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 197,901 $ — $ — $ 197,901 Commercial paper — 35,899 — 35,899 Marketable securities: U.S. Treasury securities 51,937 — — 51,937 Yankee bonds 8,232 — — 8,232 Agency bonds 8,743 — — 8,743 Municipal bonds 11,758 — — 11,758 Commercial paper — 6,945 — 6,945 Asset-backed securities — 29,607 — 29,607 Corporate bonds — 60,192 — 60,192 Total $ 278,571 $ 132,643 $ — $ 411,214 December 31, 2021 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 254,157 $ — $ — $ 254,157 Commercial paper — 22,491 — 22,491 Marketable securities: U.S. Treasury securities 52,664 — — 52,664 Yankee bonds 6,160 — — 6,160 Agency bonds 17,530 — — 17,530 Municipal bonds 12,229 — — 12,229 Commercial paper — 17,690 — 17,690 Asset-backed securities — 27,535 — 27,535 Corporate bonds — 64,755 — 64,755 Total $ 342,740 $ 132,471 $ — $ 475,211

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The following table summarizes the carrying amounts of goodwill by segment at September 30, 2022 and December 31, 2021 (in thousands): Clinical Services Pharma Services Total Balance at December 31, 2021 $ 462,603 $ 64,512 $ 527,115 Adjustment (1) (3,821) (528) (4,349) Balance at September 30, 2022 $ 458,782 $ 63,984 $ 522,766 (1) During the third quarter of 2022, we recorded a $4.3 million decrease to goodwill and corresponding decrease to deferred income tax liabilities, net, on the Consolidated Balance Sheets to correct an immaterial error related to a prior period. The error was not material to any previously reported annual or interim consolidated financial statements.
Schedule of Classes of Intangible Assets	Intangible assets consisted of the following (in thousands): September 30, 2022 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 53,172 $ 89,929 Developed Technology 10 - 15 310,226 27,787 282,439 Marketing Assets 4 549 204 345 Trademarks 15 31,473 2,699 28,774 Trade Name 5 2,584 670 1,914 Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 84,532 $ 416,848 December 31, 2021 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 45,756 $ 97,345 Developed Technology 10 - 15 310,226 11,798 298,428 Marketing Assets 4 549 100 449 Trademarks 15 31,473 1,125 30,348 Trade Name 5 2,584 276 2,308 Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 59,055 $ 442,325
Schedule of Intangible Asset Amortization Expense	The following table summarizes the amortization expense for the three and nine months ended September 30, 2022 and 2021 (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Amortization of intangibles included in cost of revenue $ 4,853 $ 4,825 $ 14,559 $ 5,554 Amortization of intangibles included in general and administrative expenses 3,637 3,649 10,911 9,129 Total amortization of intangibles $ 8,490 $ 8,474 $ 25,470 $ 14,683
Schedule of Estimated Amortization Expense	The estimated amortization expense related to amortizable intangible assets for each of the following periods as of September 30, 2022 is as follows (in thousands): Remainder of 2022 $ 8,490 2023 33,962 2024 33,961 2025 33,858 2026 33,547 Thereafter 259,583 Total $ 403,401

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Schedule of Stock Option Activity	A summary of the stock option activity under the Company’s plans for the nine months ended September 30, 2022 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2021 2,961,195 $ 25.46 Options granted 3,849,603 $ 14.94 Less: Options exercised 804,555 $ 11.35 Options forfeited 1,758,886 $ 28.75 Options outstanding at September 30, 2022 4,247,357 $ 17.23 Exercisable at September 30, 2022 1,019,075 $ 24.91
Schedule of Fair Value of Each Stock Option Award Granted	The fair value of each stock option award granted during the nine months ended September 30, 2022 was estimated as of the grant date using a Black-Scholes model with the following assumptions: Nine Months Ended Expected term (in years) 3.0 - 5.5 Risk-free interest rate (%) 1.4% - 3.4% Expected volatility (%) 42% - 60% Dividend yield (%) — Weighted average grant date fair value per share $6.51
Schedule of Restricted Stock Activity	A summary of the restricted stock activity under the Company’s plans for the nine months ended September 30, 2022 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2021 851,403 $ 36.00 Granted 2,477,418 $ 14.58 Vested (311,055) $ 36.71 Forfeited (1,022,904) $ 27.10 Nonvested at September 30, 2022 1,994,862 $ 13.84

Revenue Recognition (Tables)

Revenue Recognition (Tables)	9 Months Ended
	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Schedule of Contract Assets and Liabilities	The following table summarizes the values of contract assets, capitalized commissions and contract liabilities (in thousands): September 30, 2022 December 31, 2021 Current pharma contract assets (1) $ 2,679 $ 1,738 Long-term pharma contract assets (2) 257 236 Total pharma contract assets $ 2,936 $ 1,974 Current pharma capitalized commissions (1) $ 106 $ 109 Long-term pharma capitalized commissions (2) 1,527 882 Total pharma capitalized commissions $ 1,633 $ 991 Current pharma contract liabilities $ 6,386 $ 5,192 Long-term pharma contract liabilities (3) 1,128 917 Total pharma contract liabilities $ 7,514 $ 6,109 (1) Current pharma contract assets and Current pharma capitalized commissions are classified as other current assets on the Consolidated Balance Sheets. (2) Long-term pharma contract assets and Long-term pharma capitalized commissions are classified as other assets on the Consolidated Balance Sheets.
Schedule of Disaggregation of Revenue	The following table details the disaggregation of revenue for both the Clinical and Pharma Services Segments (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Clinical Services: Client direct billing $ 73,234 $ 64,195 $ 208,123 $ 188,040 Commercial Insurance 17,105 19,539 53,904 58,642 Medicare and Medicaid 15,795 18,295 48,427 52,929 Self-Pay 28 198 134 508 Total Clinical Services $ 106,162 $ 102,227 $ 310,588 $ 300,119 Pharma Services: 22,620 19,113 60,435 58,478 Total Revenue $ 128,782 $ 121,340 $ 371,023 $ 358,597

Net (Loss) Income Per Share (Ta

Net (Loss) Income Per Share (Tables)	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table shows the calculations (in thousands, except net loss per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 NET (LOSS) INCOME $ (36,852) $ (20,348) $ (121,563) $ 33,412 Basic weighted average shares outstanding 124,425 122,559 124,055 119,087 Dilutive effect of stock options — — — 2,077 Dilutive effect of restricted stock awards — — — 192 Dilutive effect of Convertible Notes due 2025 — — — — Dilutive effect of Convertible Notes due 2028 — — — — Diluted weighted average shares outstanding 124,425 122,559 124,055 121,356 Basic net (loss) income per share $ (0.30) $ (0.17) $ (0.98) $ 0.28 Diluted net (loss) income per share $ (0.30) $ (0.17) $ (0.98) $ 0.28
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potential dilutive shares were excluded from the calculation of diluted net (loss) income per share because their effect would be anti-dilutive (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Stock options 45 1,811 272 — Restricted stock awards 295 201 266 — 2025 Convertible Notes 5,538 5,538 5,538 5,538 2028 Convertible Notes 5,215 5,215 5,215 5,101

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Schedule of Segment Information	The following table summarizes the segment information (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 Net revenues: Clinical Services $ 106,162 $ 102,227 $ 310,588 $ 300,119 Pharma Services 22,620 19,113 60,435 58,478 Total revenue 128,782 121,340 371,023 358,597 Cost of revenue: Clinical Services (1) 65,261 59,560 197,563 178,358 Pharma Services (2) 14,628 14,541 42,389 38,436 Total cost of revenue 79,889 74,101 239,952 216,794 Gross Profit: Clinical Services 40,901 42,667 113,025 121,761 Pharma Services 7,992 4,572 18,046 20,042 Total gross profit 48,893 47,239 131,071 141,803 Operating expenses: General and administrative 64,282 63,839 188,481 158,953 Research and development 7,312 7,409 23,651 13,360 Sales and marketing 16,809 15,704 50,179 46,677 Total operating expenses 88,403 86,952 262,311 218,990 Loss from operations (39,510) (39,713) (131,240) (77,187) Interest expense, net 139 1,296 2,366 3,375 Other (income) expense, net (25) (89) 212 (431) Gain on investment in and loan receivable from non-consolidated affiliate, net — (17,750) — (109,260) (Loss) income before taxes (39,624) (23,170) (133,818) 29,129 Income tax benefit (2,772) (2,822) (12,255) (4,283) Net (loss) income $ (36,852) $ (20,348) $ (121,563) $ 33,412 (1) Clinical Services cost of revenue for both the three months ended September 30, 2022 and September 30, 2021 includes $4.3 million of amortization of acquired Inivata developed technology intangible assets. Clinical Services cost of revenue for the nine months ended September 30, 2022 include $12.8 million of amortization of acquired Inivata developed technology intangible assets. Clinical Services cost of revenue for the nine months ended September 30, 2021 include write-offs of $5.3 million for COVID-19 PCR testing inventory and $5.0 million of amortization of acquired Inivata developed technology intangible assets.

Nature of the Business - Narrat

Nature of the Business - Narrative (Details) - USD ($)	3 Months Ended			9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
PCR testing, amount recorded, COVID-19			$ 6,100,000	$ 0	$ 6,061,000
PCR testing, write-offs, COVID-19			5,300,000
PCR testing, general and administrative expenses, COVID-19	$ 0	$ 0	$ 800,000	0
COVID-19, deferred social security payroll tax	$ 3,000,000			$ 3,000,000		$ 3,000,000

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Details)	3 Months Ended	9 Months Ended
	Mar. 31, 2022 USD ($)	Sep. 30, 2022 USD ($) ft²	Jun. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Accounting Changes and Error Corrections [Abstract]
Square feet owned (in sq ft) | ft²		43,560
Assets held for sale		$ 0		$ 10,050,000
Proceeds from sale of property	$ 12,100,000
Gain on sale of property		$ 2,000,000
Impairment of goodwill			$ 0

Acquisitions - Narrative (Detai

Acquisitions - Narrative (Details) - USD ($)				3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2021	Jun. 18, 2021	Apr. 07, 2021	Sep. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021	May 31, 2020
Business Acquisition [Line Items]
Cash consideration paid						$ 0	$ 419,404,000
Common stock, par value (in dollars per share)			$ 0.001			$ 0.001		$ 0.001
Inivata Limited
Business Acquisition [Line Items]
Amount outstanding under line of credit		$ 10,300,000
Variable Interest Entity, Not Primary Beneficiary | Inivata Limited
Business Acquisition [Line Items]
Investment in minority interest									$ 25,000,000
Consideration paid to other shareholders		390,000,000
Marketing Assets
Business Acquisition [Line Items]
Amortization period of acquired intangible assets (in years)						4 years		4 years
Trademarks
Business Acquisition [Line Items]
Amortization period of acquired intangible assets (in years)						15 years		15 years
Trade Name
Business Acquisition [Line Items]
Amortization period of acquired intangible assets (in years)						5 years		5 years
Trapelo Health
Business Acquisition [Line Items]
Percentage of voting interests acquired (as a percent)			100%
Cash consideration paid			$ 35,591,000
Payments to acquire business, adjustments			600,000
Fair value of common stock at Trapelo Acquisition Date			$ 29,174,000
Shares of common stock issued as consideration (in shares)			597,712
Stock price per share on closing date (in dollars per share)			$ 48.81
Amortization period of acquired intangible assets (in years)			9 years 9 months 18 days
Goodwill, tax deductible amount			$ 0
Trapelo Health | Developed technology
Business Acquisition [Line Items]
Intangible assets, useful life (in years)			10 years
Trapelo Health | Marketing Assets
Business Acquisition [Line Items]
Intangible assets, useful life (in years)			4 years
Inivata
Business Acquisition [Line Items]
Cash consideration paid		398,594,000
Payments to acquire business, adjustments		$ 8,600,000
Amortization period of acquired intangible assets (in years)		14 years 10 months 24 days
Goodwill, tax deductible amount		$ 0
Line of credit		15,000,000
Net unrealized loss					$ 5,000,000
Fair value of previously-held equity interest	$ 64,900,000	64,906,000
Fair value of purchase option	$ 74,300,000	74,300,000
Gain on investment in and loan receivable from non-consolidated affiliate, net								$ 109,300,000
Increase in goodwill from deferred income tax liabilities		56,645,000
Measurement period adjustments, net assets acquired		17,750,000		$ 17,800,000
Gain on investment in and loan receivable from non-consolidated affiliate, net							$ 109,300,000
Inivata | Clinical Services
Business Acquisition [Line Items]
Goodwill acquired		234,600,000
Inivata | Pharma Services
Business Acquisition [Line Items]
Goodwill acquired		$ 32,400,000
Inivata | Developed technology
Business Acquisition [Line Items]
Intangible assets, useful life (in years)		15 years
Inivata | Trademarks
Business Acquisition [Line Items]
Intangible assets, useful life (in years)		15 years
Inivata | Trade Name
Business Acquisition [Line Items]
Intangible assets, useful life (in years)		5 years

Acquisitions - Schedule of Prov

Acquisitions - Schedule of Provisional Information (Details) - USD ($) $ / shares in Units, $ in Thousands				3 Months Ended	9 Months Ended
	Sep. 30, 2021	Jun. 18, 2021	Apr. 07, 2021	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Business Acquisition [Line Items]
Plus: Cash paid at closing					$ 0	$ 419,404
Goodwill					$ 522,766		$ 527,115
Trapelo Health
Business Acquisition [Line Items]
Shares of common stock issued as consideration (in shares)			597,712
Per share value of common stock issued as consideration (in dollars per share)			$ 48.81
Fair value of common stock at Trapelo Acquisition Date			$ 29,174
Plus: Cash paid at closing			35,591
Fair value of consideration transferred			64,765
Cash			713
Other current assets			282
Other long-term assets			268
Total identifiable assets acquired			20,852
Current liabilities			(751)
Net identifiable assets acquired			20,101
Goodwill			44,664
Total purchase consideration			64,765
Trapelo Health | Marketing Assets
Business Acquisition [Line Items]
Intangible assets			549
Trapelo Health | Developed technology
Business Acquisition [Line Items]
Intangible assets			$ 19,040
Inivata
Business Acquisition [Line Items]
Plus: Cash paid at closing		$ 398,594
Fair value of Line of Credit		15,000
Fair value of consideration transferred		413,594
Measurement period adjustments, fair value of previously-held equity interest		1,987
Fair value of previously-held equity interest	$ 64,900	64,906
Measurement period adjustments, fair value of Purchase Option		15,763
Fair value of purchase option	$ 74,300	74,300
Measurement period adjustments, net assets acquired		17,750		$ 17,800
Total fair value of business combination		552,800
Cash		14,068
Measurement period adjustments, other current assets		345
Other current assets		5,711
Property and equipment		1,753
Other long-term assets		6,240
Measurement period adjustments, total identifiable assets acquired		(11,424)
Total identifiable assets acquired		353,007
Measurement period adjustments, current liabilities		(1,650)
Current liabilities		(5,891)
Measurement period adjustments, deferred income tax liabilities		3,686
Deferred income tax liabilities		(56,645)
Other long-term liabilities		(4,690)
Measurement period adjustments, net identifiable assets acquired		(9,388)
Net identifiable assets acquired		285,781
Measurement period adjustments, goodwill		27,138
Goodwill		267,019
Total purchase consideration		552,800
Inivata | Error Correction, Other
Business Acquisition [Line Items]
Measurement period adjustments, deferred income tax liabilities		4,349
Measurement period adjustments, net identifiable assets acquired		4,349
Measurement period adjustments, goodwill		(4,349)
Inivata | Previously Reported
Business Acquisition [Line Items]
Plus: Cash paid at closing		398,594
Fair value of Line of Credit		15,000
Fair value of consideration transferred		413,594
Fair value of previously-held equity interest		62,919
Fair value of purchase option		58,537
Total fair value of business combination		535,050
Cash		14,068
Other current assets		5,366
Property and equipment		1,753
Other long-term assets		6,240
Total identifiable assets acquired		364,431
Current liabilities		(4,241)
Deferred income tax liabilities		(64,680)
Other long-term liabilities		(4,690)
Net identifiable assets acquired		290,820
Goodwill		244,230
Total purchase consideration		535,050
Inivata | Developed technology
Business Acquisition [Line Items]
Measurement period adjustments, identifiable intangible assets		(11,796)
Intangible assets		291,186
Inivata | Developed technology | Previously Reported
Business Acquisition [Line Items]
Intangible assets		302,982
Inivata | Trademarks
Business Acquisition [Line Items]
Measurement period adjustments, identifiable intangible assets		(226)
Intangible assets		31,474
Inivata | Trademarks | Previously Reported
Business Acquisition [Line Items]
Intangible assets		31,700
Inivata | Trade Name
Business Acquisition [Line Items]
Measurement period adjustments, identifiable intangible assets		253
Intangible assets		2,575
Inivata | Trade Name | Previously Reported
Business Acquisition [Line Items]
Intangible assets		$ 2,322

Acquisitions - Pro Forma Inform

Acquisitions - Pro Forma Information (Details) - Inivata - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2021
Business Acquisition [Line Items]
Net revenue	$ 121,340	$ 358,499
Net loss	$ (37,017)	$ (88,134)

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Amortized Cost (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	$ 182,782	$ 199,464
Gross Unrealized Gains	0	22
Gross Unrealized Losses	(5,368)	(923)
Fair Value	177,414	198,563
Accrued interest receivable	700	600
U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	52,826	52,791
Gross Unrealized Gains	0	11
Gross Unrealized Losses	(889)	(138)
Fair Value	51,937	52,664
Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	8,373	6,175
Gross Unrealized Gains	0	1
Gross Unrealized Losses	(141)	(16)
Fair Value	8,232	6,160
Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	8,890	17,546
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(147)	(16)
Fair Value	8,743	17,530
Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	12,877	12,440
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(1,119)	(211)
Fair Value	11,758	12,229
Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	6,974	17,694
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(29)	(4)
Fair Value	6,945	17,690
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	30,117	27,620
Gross Unrealized Gains	0	1
Gross Unrealized Losses	(510)	(86)
Fair Value	29,607	27,535
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	62,725	65,198
Gross Unrealized Gains	0	9
Gross Unrealized Losses	(2,533)	(452)
Fair Value	$ 60,192	$ 64,755

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value by Contractual Maturity (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	$ 112,167	$ 104,711
Over One Year Through Five Years	65,247	93,852
Over Five Years	0	0
Total	177,414	198,563
U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	36,102	22,550
Over One Year Through Five Years	15,835	30,114
Over Five Years	0	0
Total	51,937	52,664
Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	5,704	4,150
Over One Year Through Five Years	2,528	2,010
Over Five Years	0	0
Total	8,232	6,160
Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	6,419	14,041
Over One Year Through Five Years	2,324	3,489
Over Five Years	0	0
Total	8,743	17,530
Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	0	0
Over One Year Through Five Years	11,758	12,229
Over Five Years	0	0
Total	11,758	12,229
Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	6,945	17,690
Over One Year Through Five Years	0	0
Over Five Years	0	0
Total	6,945	17,690
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	25,052	20,868
Over One Year Through Five Years	4,555	6,667
Over Five Years	0	0
Total	29,607	27,535
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	31,945	25,412
Over One Year Through Five Years	28,247	39,343
Over Five Years	0	0
Total	$ 60,192	$ 64,755

Fair Value Measurements - Asset

Fair Value Measurements - Assets Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	$ 177,414	$ 198,563
U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	51,937	52,664
Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	8,232	6,160
Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	8,743	17,530
Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	11,758	12,229
Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	6,945	17,690
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	29,607	27,535
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	60,192	64,755
Fair Value, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	411,214	475,211
Fair Value, Recurring | Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	197,901	254,157
Fair Value, Recurring | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	35,899	22,491
Fair Value, Recurring | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	51,937	52,664
Fair Value, Recurring | Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	8,232	6,160
Fair Value, Recurring | Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	8,743	17,530
Fair Value, Recurring | Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	11,758	12,229
Fair Value, Recurring | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	6,945	17,690
Fair Value, Recurring | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	29,607	27,535
Fair Value, Recurring | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	60,192	64,755
Fair Value, Recurring | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	278,571	342,740
Fair Value, Recurring | Level 1 | Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	197,901	254,157
Fair Value, Recurring | Level 1 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	0	0
Fair Value, Recurring | Level 1 | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	51,937	52,664
Fair Value, Recurring | Level 1 | Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	8,232	6,160
Fair Value, Recurring | Level 1 | Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	8,743	17,530
Fair Value, Recurring | Level 1 | Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	11,758	12,229
Fair Value, Recurring | Level 1 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 1 | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 1 | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	132,643	132,471
Fair Value, Recurring | Level 2 | Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	0	0
Fair Value, Recurring | Level 2 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	35,899	22,491
Fair Value, Recurring | Level 2 | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 2 | Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 2 | Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 2 | Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 2 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	6,945	17,690
Fair Value, Recurring | Level 2 | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	29,607	27,535
Fair Value, Recurring | Level 2 | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	60,192	64,755
Fair Value, Recurring | Level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	0	0
Fair Value, Recurring | Level 3 | Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	0	0
Fair Value, Recurring | Level 3 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	0	0
Fair Value, Recurring | Level 3 | U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 3 | Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 3 | Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 3 | Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 3 | Commercial paper
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 3 | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	0	0
Fair Value, Recurring | Level 3 | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	$ 0	$ 0

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Schedule of Goodwill (Details) - USD ($) $ in Thousands		9 Months Ended
	Jun. 18, 2021	Sep. 30, 2022
Goodwill [Roll Forward]
Goodwill, beginning balance		$ 527,115
Adjustment		(4,349)
Goodwill, ending balance		522,766
Inivata
Goodwill [Roll Forward]
Goodwill, ending balance	$ 267,019
Measurement period adjustments, goodwill	(27,138)
Inivata | Error Correction, Other
Goodwill [Roll Forward]
Measurement period adjustments, goodwill	$ 4,349
Clinical Services
Goodwill [Roll Forward]
Goodwill, beginning balance		462,603
Adjustment		(3,821)
Goodwill, ending balance		458,782
Pharma Services
Goodwill [Roll Forward]
Goodwill, beginning balance		64,512
Adjustment		(528)
Goodwill, ending balance		$ 63,984

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Classes of Intangible Assets (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Total cost of intangibles	$ 501,380	$ 501,380
Accumulated Amortization	84,532	59,055
Finite-lived intangibles, net	403,401
Intangible assets, net	416,848	442,325
Trademarks
Finite-Lived Intangible Assets [Line Items]
Trademark - Indefinite lived	13,447	13,447
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Cost	143,101	143,101
Accumulated Amortization	53,172	45,756
Finite-lived intangibles, net	89,929	97,345
Developed Technology
Finite-Lived Intangible Assets [Line Items]
Cost	310,226	310,226
Accumulated Amortization	27,787	11,798
Finite-lived intangibles, net	$ 282,439	$ 298,428
Marketing Assets
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	4 years	4 years
Cost	$ 549	$ 549
Accumulated Amortization	204	100
Finite-lived intangibles, net	$ 345	$ 449
Trademarks
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	15 years	15 years
Cost	$ 31,473	$ 31,473
Accumulated Amortization	2,699	1,125
Finite-lived intangibles, net	$ 28,774	$ 30,348
Trade Name
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	5 years	5 years
Cost	$ 2,584	$ 2,584
Accumulated Amortization	670	276
Finite-lived intangibles, net	$ 1,914	$ 2,308
Minimum | Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	7 years	7 years
Minimum | Developed Technology
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	10 years	10 years
Maximum | Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	15 years	15 years
Maximum | Developed Technology
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	15 years	15 years

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Schedule of Amortization Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Finite-Lived Intangible Assets [Line Items]
Total amortization of intangibles	$ 8,490	$ 8,474	$ 25,470	$ 14,683
Amortization of intangibles included in cost of revenue
Finite-Lived Intangible Assets [Line Items]
Total amortization of intangibles	4,853	4,825	14,559	5,554
Amortization of intangibles included in general and administrative expenses
Finite-Lived Intangible Assets [Line Items]
Total amortization of intangibles	$ 3,637	$ 3,649	$ 10,911	$ 9,129

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Estimated Amortization Expense (Details) $ in Thousands	Sep. 30, 2022 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2022	$ 8,490
2023	33,962
2024	33,961
2025	33,858
2026	33,547
Thereafter	259,583
Total	$ 403,401

Debt (Details)

Debt (Details) - Convertible Debt	3 Months Ended			9 Months Ended
	Sep. 30, 2022 USD ($) day	Jun. 30, 2022 day	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 Rate	Sep. 30, 2022 $ / shares	Sep. 30, 2022	Dec. 31, 2021 USD ($) Rate	Jan. 11, 2021 USD ($) Rate	May 04, 2020 USD ($) Rate
0.25% Convertible Senior Notes
Line of Credit Facility [Line Items]
Debt instrument, face amount										$ 345,000,000
Stated interest rate (as a percent) | Rate						0.25%			0.25%	0.25%
Convertible Notes, conversion price (in dollars per share) | $ / shares							$ 8.61
Interest expense, contractual coupon interest	$ 200,000		$ 200,000	$ 700,000	$ 600,000
Interest expense, accretion of debt discount	400,000		400,000	1,100,000	1,000,000
Interest expense, amortization of debt issuance costs	8,500		8,400	$ 25,300	23,700
Effective interest rate on Convertible Notes (as a percent)				0.70%
0.25% Convertible Senior Notes | Level 2
Line of Credit Facility [Line Items]
Estimated fair value of debt	217,400,000			$ 217,400,000					$ 297,600,000
1.25% Convertible Senior Notes
Line of Credit Facility [Line Items]
Debt instrument, face amount											$ 201,300,000
Stated interest rate (as a percent)						1.25%		1.25%	1.25%		1.25%
Convertible Notes, conversion price (in dollars per share) | $ / shares							$ 8.61
Interest expense, contractual coupon interest	600,000		600,000	1,900,000	1,900,000
Interest expense, accretion of debt discount	300,000		300,000	900,000	900,000
Interest expense, amortization of debt issuance costs	37,200		$ 36,500	$ 100,000	$ 100,000
Effective interest rate on Convertible Notes (as a percent)				1.96%
1.25% Convertible Senior Notes | Level 2
Line of Credit Facility [Line Items]
Estimated fair value of debt	$ 171,100,000			$ 171,100,000					$ 238,900,000
1.25% Convertible Senior Notes | Debt Instrument, Redemption, Period One
Line of Credit Facility [Line Items]
Conversion price on applicable trading day (as a percent)	130%	130%
Threshold trading days (in days) | day	20	20
Consecutive trading days (in days) | day	30	30

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) - USD ($) $ in Millions	3 Months Ended				9 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense (gain)	$ 4.3			$ 5.2	$ 20	$ 12.4
Unrecognized stock-based compensation cost	14.8				$ 14.8
Unrecognized share-based compensation expense, weighted-average recognition period (in years)					2 years 2 months 12 days
Chief Legal Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Incremental stock-based compensation for accelerated vesting					$ 2.2
Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Incremental stock-based compensation for accelerated vesting					5.9
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation cost	19.8				$ 19.8
Unrecognized share-based compensation expense, weighted-average recognition period (in years)					2 years 2 months 12 days
Restricted Stock | Chief Legal Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting (in shares)		76,138
Incremental stock-based compensation for accelerated vesting					$ 1.9
Restricted Stock | Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting (in shares)			142,302
Incremental stock-based compensation for accelerated vesting	0				3.6
Stock options | Chief Legal Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting (in shares)		41,487
Incremental stock-based compensation for accelerated vesting					0.3
Stock options | Chief Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting (in shares)			237,960
Incremental stock-based compensation for accelerated vesting	$ 0				$ 2.3

Stock-Based Compensation - Summ

Stock-Based Compensation - Summary of Stock Option Activity (Details) - $ / shares	9 Months Ended
	Sep. 30, 2022
Number of Shares
Beginning balance (in shares)	2,961,195
Options granted (in shares)	3,849,603
Less:
Options exercised (in shares)	804,555
Options forfeited (in shares)	1,758,886
Ending balance (in shares)	4,247,357
Exercisable at end of period (in shares)	1,019,075
Weighted Average Exercise Price
Beginning balance (in dollars per share)	$ 25.46
Granted (in dollars per share)	14.94
Less:
Exercised (in dollars per share)	11.35
Forfeited (in dollars per share)	28.75
Ending balance (in dollars per share)	17.23
Exercisable, ending balance (in dollars per share)	$ 24.91

Stock-Based Compensation - Fair

Stock-Based Compensation - Fair Value of Each Stock Option Award Granted (Details)	9 Months Ended
	Sep. 30, 2022 $ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield (%)	0%
Weighted average fair value/share at grant date (in dollars per share)	$ 6.51
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	3 years
Risk-free interest rate (%)	1.40%
Expected volatility (%)	42%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 6 months
Risk-free interest rate (%)	3.40%
Expected volatility (%)	60%

Stock-Based Compensation - Su_2

Stock-Based Compensation - Summary of Restricted Stock Activity (Details) - Restricted Stock	9 Months Ended
	Sep. 30, 2022 $ / shares shares
Number of Restricted Shares
Beginning balance (in shares) | shares	851,403
Granted (in shares) | shares	2,477,418
Vested (in shares) | shares	(311,055)
Forfeited (in shares) | shares	(1,022,904)
Ending balance (in shares) | shares	1,994,862
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share) | $ / shares	$ 36
Granted (in dollars per share) | $ / shares	14.58
Vested (in dollars per share) | $ / shares	36.71
Forfeited (in dollars per share) | $ / shares	27.10
Ending balance (in dollars per share) | $ / shares	$ 13.84

Revenue Recognition - Narrative

Revenue Recognition - Narrative (Details) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022 USD ($)	Sep. 30, 2021 USD ($)	Sep. 30, 2022 USD ($) segment	Sep. 30, 2021 USD ($)
Revenue from Contract with Customer [Abstract]
Number of operating segments | segment			2
Revenue payment terms			Collection of consideration the Company expects to receive typically occurs within 90 to 120 days of billing for commercial insurance, Medicare and other governmental and self-pay payers and within 60 to 90 days of billing for client payers.
Pharma contract liability, revenue recognized	$ 0.7	$ 0.4	$ 4.8	$ 4.2
Amortization of contract commissions	$ 0.3	$ 0.2	$ 0.6	$ 0.9

Revenue Recognition - Contract

Revenue Recognition - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2022	Dec. 31, 2021
Contract with Customer, Asset, Net [Abstract]
Current pharma contract assets	$ 2,679	$ 1,738
Long-term pharma contract assets	257	236
Total pharma contract assets	2,936	1,974
Capitalized Contract Cost [Abstract]
Current pharma capitalized commissions	106	109
Long-term pharma capitalized commissions	1,527	882
Total pharma capitalized commissions	1,633	991
Contract with Customer, Liability [Abstract]
Current pharma contract liabilities	6,386	5,192
Long-term pharma contract liabilities	1,128	917
Total pharma contract liabilities	$ 7,514	$ 6,109

Revenue Recognition - Disaggreg

Revenue Recognition - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Disaggregation of Revenue [Line Items]
Total Revenue	$ 128,782	$ 121,340	$ 371,023	$ 358,597
Clinical Services
Disaggregation of Revenue [Line Items]
Total Revenue	106,162	102,227	310,588	300,119
Clinical Services | Client direct billing
Disaggregation of Revenue [Line Items]
Total Revenue	73,234	64,195	208,123	188,040
Clinical Services | Commercial Insurance
Disaggregation of Revenue [Line Items]
Total Revenue	17,105	19,539	53,904	58,642
Clinical Services | Medicare and Medicaid
Disaggregation of Revenue [Line Items]
Total Revenue	15,795	18,295	48,427	52,929
Clinical Services | Self-Pay
Disaggregation of Revenue [Line Items]
Total Revenue	28	198	134	508
Pharma Services
Disaggregation of Revenue [Line Items]
Total Revenue	$ 22,620	$ 19,113	$ 60,435	$ 58,478

Net (Loss) Income Per Share - S

Net (Loss) Income Per Share - Schedule of Basic and Diluted Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
NET (LOSS) INCOME	$ (36,852)	$ (20,348)	$ (121,563)	$ 33,412
Basic weighted average shares outstanding (in shares)	124,425	122,559	124,055	119,087
Diluted weighted average shares outstanding (in shares)	124,425	122,559	124,055	121,356
Basic net income (loss) per share (in dollars per share)	$ (0.30)	$ (0.17)	$ (0.98)	$ 0.28
Diluted net income (loss) per share (in dollars per share)	$ (0.30)	$ (0.17)	$ (0.98)	$ 0.28
1.25% Convertible Senior Notes
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Dilutive effect of Convertible Notes (in shares)	0	0	0	0
0.25% Convertible Senior Notes
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Dilutive effect of Convertible Notes (in shares)	0	0	0	0
Stock options
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Dilutive effect of stock options and restricted stock awards (in shares)	0	0	0	2,077
Restricted Stock
Earnings Per Share, Basic, by Common Class, Including Two Class Method [Line Items]
Dilutive effect of stock options and restricted stock awards (in shares)	0	0	0	192

Net (Loss) Income Per Share -_2

Net (Loss) Income Per Share - Schedule of Antidilutive Shares (Details) - USD ($) $ / shares in Units, $ in Thousands		3 Months Ended		9 Months Ended
	Jan. 11, 2021	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Proceeds from issuance of convertible debt, net of issuance costs				$ 0	$ 334,410
Capped Call Transactions
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Proceeds from issuance of convertible debt, net of issuance costs	$ 29,300
Offering price per share (in dollars per share)		$ 85.75		$ 85.75
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		45,000	1,811,000	272,000	0
Restricted Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		295,000	201,000	266,000	0
Convertible Debt Securities | 1.25% Convertible Senior Notes
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		5,538,000	5,538,000	5,538,000	5,538,000
Convertible Debt Securities | 0.25% Convertible Senior Notes
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		5,215,000	5,215,000	5,215,000	5,101,000

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions	Jan. 20, 2021 patent	Sep. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Patent Infringement Complaint
Contractual Obligation [Line Items]
Number of patents allegedly infringed upon | patent	2
Federal Healthcare Program Revenue
Contractual Obligation [Line Items]
Loss contingency accrual | $		$ 11.2	$ 11.2

Related Party Transactions (Det

Related Party Transactions (Details) - Affiliated Entity - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Strategic Alliance With Inivata Limited
Related Party Transaction [Line Items]
Payments to related party				$ 0.8
Pharma Service Contracts with CytomX Therapeutics, Inc.
Related Party Transaction [Line Items]
Revenue from related party	$ 0.1	$ 0.2	$ 0.5	0.4
Pharma Services contracts with HOOKIPA Pharma, Inc
Related Party Transaction [Line Items]
Revenue from related party	$ 0.3	$ 0.2	$ 0.3	$ 0.4

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2022 USD ($)	Jun. 30, 2022 USD ($)	Mar. 31, 2022 USD ($)	Sep. 30, 2021 USD ($)	Jun. 30, 2021 USD ($)	Mar. 31, 2021 USD ($)	Sep. 30, 2022 USD ($) segment	Sep. 30, 2021 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment							2
Segment Reporting Information [Line Items]
Total Revenue	$ 128,782			$ 121,340			$ 371,023	$ 358,597
Total cost of revenue	79,889			74,101			239,952	216,794
GROSS PROFIT	48,893			47,239			131,071	141,803
General and administrative	64,282			63,839			188,481	158,953
Research and development	7,312			7,409			23,651	13,360
Sales and marketing	16,809			15,704			50,179	46,677
Total operating expenses	88,403			86,952			262,311	218,990
Loss from operations	(39,510)			(39,713)			(131,240)	(77,187)
Interest expense, net	139			1,296			2,366	3,375
Other (income) expense, net	(25)			(89)			212	(431)
Gain on investment in and loan receivable from non-consolidated affiliate, net	0			(17,750)			0	(109,260)
(Loss) income before taxes	(39,624)			(23,170)			(133,818)	29,129
Income tax benefit	(2,772)			(2,822)			(12,255)	(4,283)
NET (LOSS) INCOME	(36,852)	$ (35,303)	$ (49,408)	(20,348)	$ 75,873	$ (22,114)	(121,563)	33,412
Clinical Services
Segment Reporting Information [Line Items]
Total Revenue	106,162			102,227			310,588	300,119
Total cost of revenue	65,261			59,560			197,563	178,358
GROSS PROFIT	40,901			42,667			113,025	121,761
Amortization of acquired intangible assets	4,300			4,300			12,800	5,000
Clinical Services | COVID-19 PCR Testing
Segment Reporting Information [Line Items]
Write off of COVID-19 PCR testing inventory								5,300
Pharma Services
Segment Reporting Information [Line Items]
Total Revenue	22,620			19,113			60,435	58,478
Total cost of revenue	14,628			14,541			42,389	38,436
GROSS PROFIT	7,992			4,572			18,046	20,042
Amortization of acquired intangible assets	$ 600			$ 600			$ 1,800	$ 600