NeoGenomics (NEO) 10-Q 30 Jul 24 2024 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2024	Jul. 26, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
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		128,158,151
Entity Central Index Key	0001077183
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 355,085	$ 342,488
Marketable securities, at fair value	32,770	72,715
Accounts receivable, net	146,581	131,227
Inventories	23,214	24,156
Prepaid assets	17,396	17,987
Other current assets	9,157	8,239
Total current assets	584,203	596,812
Property and equipment (net of accumulated depreciation of $176,335 and $158,211, respectively)	92,158	92,012
Operating lease right-of-use assets	83,671	91,769
Intangible assets, net	356,404	373,128
Goodwill	522,766	522,766
Other assets	4,075	4,742
Total non-current assets	1,059,074	1,084,417
Total assets	1,643,277	1,681,229
Current liabilities
Accounts payable	17,186	20,334
Accrued compensation	50,880	53,161
Accrued expenses and other liabilities	17,274	15,069
Current portion of operating lease liabilities	3,574	5,610
Current portion of convertible senior notes, net	200,073	0
Contract liabilities	972	2,130
Total current liabilities	289,959	96,304
Long-term liabilities
Operating lease liabilities	63,294	67,871
Convertible senior notes, net	339,577	538,198
Deferred income tax liabilities, net	23,015	24,285
Other long-term liabilities	11,548	13,034
Total long-term liabilities	437,434	643,388
Total liabilities	727,393	739,692
Commitments and contingencies (Note 11)
Stockholders’ equity
Common stock, $0.001 par value, (250,000,000 shares authorized; 127,851,113 and 127,369,142 shares issued and outstanding, respectively)	128	127
Additional paid-in capital	1,209,536	1,190,139
Accumulated other comprehensive loss	(1,022)	(1,674)
Accumulated deficit	(292,758)	(247,055)
Total stockholders’ equity	915,884	941,537
Total liabilities and stockholders’ equity	$ 1,643,277	$ 1,681,229

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 176,335	$ 158,211
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)	127,851,113	127,369,142
Common stock, shares outstanding (in shares)	127,851,113	127,369,142

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Total net revenue	$ 164,502	$ 146,917	$ 320,742	$ 284,137
COST OF REVENUE	92,008	87,026	182,779	169,432
GROSS PROFIT	72,494	59,891	137,963	114,705
Operating expenses:
General and administrative	63,328	60,308	129,125	121,857
Research and development	7,886	7,502	15,506	14,897
Sales and marketing	21,677	18,901	41,898	35,160
Restructuring charges	1,544	3,074	3,942	7,758
Total operating expenses	94,435	89,785	190,471	179,672
LOSS FROM OPERATIONS	(21,941)	(29,894)	(52,508)	(64,967)
Interest income	(4,592)	(4,308)	(9,426)	(7,532)
Interest expense	1,666	1,784	3,351	3,541
Other expense (income), net	2	(730)	265	(616)
Loss before taxes	(19,017)	(26,640)	(46,698)	(60,360)
Income tax benefit	(375)	(2,309)	(995)	(5,234)
NET LOSS	$ (18,642)	$ (24,331)	$ (45,703)	$ (55,126)
NET LOSS PER SHARE
Basic (in dollars per share)	$ (0.15)	$ (0.19)	$ (0.36)	$ (0.44)
Diluted (in dollars per share)	$ (0.15)	$ (0.19)	$ (0.36)	$ (0.44)
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic (in shares)	126,405	125,356	126,257	125,192
Diluted (in shares)	126,405	125,356	126,257	125,192
Clinical Services
Total net revenue	$ 141,388	$ 123,156	$ 275,923	$ 238,025
COST OF REVENUE	78,094	71,746	154,938	139,038
GROSS PROFIT	63,294	51,410	120,985	98,987
Advanced Diagnostics
Total net revenue	23,114	23,761	44,819	46,112
COST OF REVENUE	13,914	15,280	27,841	30,394
GROSS PROFIT	$ 9,200	$ 8,481	$ 16,978	$ 15,718

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Comprehensive Income [Abstract]
NET LOSS	$ (18,642)	$ (24,331)	$ (45,703)	$ (55,126)
OTHER COMPREHENSIVE INCOME:
Net unrealized gain on marketable securities, net of tax	308	262	652	1,327
Total other comprehensive income, net of tax	308	262	652	1,327
COMPREHENSIVE LOSS	$ (18,334)	$ (24,069)	$ (45,051)	$ (53,799)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Loss	Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2022		126,913,992
Beginning balance at Dec. 31, 2022	$ 998,023	$ 127	$ 1,160,882	$ (3,899)	$ (159,087)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for ESPP (in shares)		96,733
Issuance of common stock for ESPP	811		811
Issuance of restricted stock, net of forfeitures (in shares)		114,738
Issuance of restricted stock, net of forfeitures	(147)		(147)
Issuance of common stock for stock options (in shares)		75,028
Issuance of common stock for stock options	751		751
Stock issuance fees and expenses	(4)		(4)
Stock-based compensation expense	4,758		4,758
Net unrealized gain on marketable securities, net of tax	1,065			1,065
Net loss	(30,795)				(30,795)
Ending balance (in shares) at Mar. 31, 2023		127,200,491
Ending balance at Mar. 31, 2023	974,462	$ 127	1,167,051	(2,834)	(189,882)
Beginning balance (in shares) at Dec. 31, 2022		126,913,992
Beginning balance at Dec. 31, 2022	998,023	$ 127	1,160,882	(3,899)	(159,087)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net unrealized gain on marketable securities, net of tax	1,327
Net loss	(55,126)
Ending balance (in shares) at Jun. 30, 2023		127,144,418
Ending balance at Jun. 30, 2023	956,192	$ 127	1,172,850	(2,572)	(214,213)
Beginning balance (in shares) at Mar. 31, 2023		127,200,491
Beginning balance at Mar. 31, 2023	974,462	$ 127	1,167,051	(2,834)	(189,882)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for ESPP (in shares)		78,302
Issuance of common stock for ESPP	1,029		1,029
Issuance of restricted stock, net of forfeitures (in shares)		(194,448)
Issuance of restricted stock, net of forfeitures	(1,527)		(1,527)
Issuance of common stock for stock options (in shares)		60,073
Issuance of common stock for stock options	610		610
Stock issuance fees and expenses	(18)		(18)
Stock-based compensation expense	5,705		5,705
Net unrealized gain on marketable securities, net of tax	262			262
Net loss	(24,331)				(24,331)
Ending balance (in shares) at Jun. 30, 2023		127,144,418
Ending balance at Jun. 30, 2023	$ 956,192	$ 127	1,172,850	(2,572)	(214,213)
Beginning balance (in shares) at Dec. 31, 2023	127,369,142	127,369,142
Beginning balance at Dec. 31, 2023	$ 941,537	$ 127	1,190,139	(1,674)	(247,055)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for ESPP (in shares)		70,278
Issuance of common stock for ESPP	917		917
Issuance of restricted stock, net of forfeitures (in shares)		(17,398)
Issuance of restricted stock, net of forfeitures	(199)		(199)
Issuance of common stock for stock options (in shares)		12,764
Issuance of common stock for stock options	102		102
Stock issuance fees and expenses	(4)		(4)
Stock-based compensation expense	7,774		7,774
Net unrealized gain on marketable securities, net of tax	344			344
Net loss	(27,061)				(27,061)
Ending balance (in shares) at Mar. 31, 2024		127,434,786
Ending balance at Mar. 31, 2024	$ 923,410	$ 127	1,198,729	(1,330)	(274,116)
Beginning balance (in shares) at Dec. 31, 2023	127,369,142	127,369,142
Beginning balance at Dec. 31, 2023	$ 941,537	$ 127	1,190,139	(1,674)	(247,055)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for stock options (in shares)	294,372
Net unrealized gain on marketable securities, net of tax	$ 652
Net loss	$ (45,703)
Ending balance (in shares) at Jun. 30, 2024	127,851,113	127,851,113
Ending balance at Jun. 30, 2024	$ 915,884	$ 128	1,209,536	(1,022)	(292,758)
Beginning balance (in shares) at Mar. 31, 2024		127,434,786
Beginning balance at Mar. 31, 2024	923,410	$ 127	1,198,729	(1,330)	(274,116)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock for ESPP (in shares)		102,112
Issuance of common stock for ESPP	1,280		1,280
Issuance of restricted stock, net of forfeitures (in shares)		32,607
Issuance of restricted stock, net of forfeitures	(1,631)		(1,631)
Issuance of common stock for stock options (in shares)		281,608
Issuance of common stock for stock options	2,321	$ 1	2,320
Stock issuance fees and expenses	(3)		(3)
Stock-based compensation expense	8,841		8,841
Net unrealized gain on marketable securities, net of tax	308			308
Net loss	$ (18,642)				(18,642)
Ending balance (in shares) at Jun. 30, 2024	127,851,113	127,851,113
Ending balance at Jun. 30, 2024	$ 915,884	$ 128	$ 1,209,536	$ (1,022)	$ (292,758)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss	$ (45,703)	$ (55,126)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation	19,651	18,523
Amortization of intangibles	16,723	17,566
Stock-based compensation	16,615	10,463
Non-cash operating lease expense	4,793	4,648
Amortization of convertible debt discount	1,358	1,341
Amortization of debt issue costs	94	92
Impairment of assets	333	1,660
Other adjustments	159	5
Changes in assets and liabilities, net
Accounts receivable, net	(15,353)	(5,713)
Inventories	835	(888)
Prepaid and other assets	316	(2,614)
Operating lease liabilities	(3,308)	(3,294)
Deferred income tax liabilities, net	(1,270)	(5,939)
Accrued compensation	(2,281)	5,545
Accounts payable and other liabilities	(4,985)	(509)
Net cash used in operating activities	(12,023)	(14,240)
CASH FLOWS FROM INVESTING ACTIVITIES
Purchases of marketable securities	0	(6,756)
Proceeds from maturities of marketable securities	40,501	62,868
Purchases of property and equipment	(18,663)	(17,421)
Net cash provided by investing activities	21,838	38,691
CASH FLOWS FROM FINANCING ACTIVITIES
Repayment of equipment financing obligations	0	(61)
Issuance of common stock, net	2,782	1,504
Net cash provided by financing activities	2,782	1,443
Net change in cash and cash equivalents	12,597	25,894
Cash and cash equivalents, beginning of period	342,488	263,180
Cash and cash equivalents, end of period	355,085	289,074
Supplemental disclosure of cash flow information:
Interest paid	1,691	1,690
Income taxes paid, net	176	175
Supplemental disclosure of non-cash investing and financing information:
Purchases of property and equipment included in accounts payable	$ 2,042	$ 838

Nature of the Business

Nature of the Business	6 Months Ended
	Jun. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of the Business	Nature of the Business NeoGenomics, Inc., a Nevada corporation (the “Company,” or “NeoGenomics”), and its subsidiaries provide a wide range of oncology diagnostic testing and consultative services which includes technical laboratory services and professional interpretation of laboratory test results by licensed physicians who specialize in pathology and oncology. The Company operates a network of cancer-focused testing laboratories in the United States and the United Kingdom.

Summary of Significant Accounti

Summary of Significant Accounting Policies	6 Months Ended
	Jun. 30, 2024
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 generally accepted accounting principles in the United States (“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, 2023, 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, 2023. 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, impairment analysis of goodwill, and restructuring reserves. 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. 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 six months ended June 30, 2024 and 2023. Restructuring charges Restructuring charges relate to a restructuring program to improve execution and drive efficiency across the organization. Restructuring charges consist of severance and other employee costs, costs for optimizing the Company’s geographic presence, and consulting and other costs. For further details on the Company’s restructuring activities, please refer to Note 8. Restructuring. Accounting Pronouncements Pending Adoption In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This update requires entities to consistently categorize and provide greater disaggregation of information in the rate reconciliation and to further disaggregate income taxes paid by jurisdiction. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. ASU 2023-07 may be applied retrospectively or prospectively. The Company is currently evaluating the impact of this standard on its annual disclosures. In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. This update requires entities to disclose significant segment expenses by reportable segment if they are regularly provided to the Chief Operating Decision Maker (CODM) and included in each reported measure of segment profit or loss and requires disclosure of other segment items by reportable segment and a description of its composition. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023 and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. ASU 2023-07 should be applied retrospectively to all prior periods presented in the financial statements. The Company is currently evaluating the impact of this standard on its annual disclosures.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2024
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 and are included in cash and cash equivalents on the Consolidated Balance Sheets. 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 June 30, 2024 and December 31, 2023. June 30, 2024 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: Agency bonds 2,481 — (32) 2,449 Municipal bonds 12,621 — (407) 12,214 Asset-backed securities 283 — — 283 Corporate bonds 18,221 — (397) 17,824 Total $ 33,606 $ — $ (836) $ 32,770 December 31, 2023 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: U.S. Treasury securities $ 15,437 $ — $ (64) $ 15,373 Yankee bonds 2,601 — (13) 2,588 Agency bonds 6,056 — (56) 6,000 Municipal bonds 12,694 — (597) 12,097 Asset-backed securities 4,971 — (37) 4,934 Corporate bonds 32,442 — (719) 31,723 Total $ 74,201 $ — $ (1,486) $ 72,715 The Company had $1.5 million and $1.7 million of accrued interest receivable at June 30, 2024 and December 31, 2023, respectively, included in other current assets on its Consolidated Balance Sheets related to its marketable securities. There were no realized gains or losses on marketable securities for the three and six months ended June 30, 2024 and June 30, 2023. The following tables set forth the fair value of available-for-sale marketable securities by contractual maturity at June 30, 2024 and December 31, 2023. June 30, 2024 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: Agency bonds 2,449 — — 2,449 Municipal bonds 6,454 5,760 — 12,214 Asset-backed securities 283 — — 283 Corporate bonds 14,979 2,845 — 17,824 Total $ 24,165 $ 8,605 $ — $ 32,770 December 31, 2023 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: U.S. Treasury securities $ 15,373 $ — $ — $ 15,373 Yankee bonds 2,588 — — 2,588 Agency bonds 6,000 — — 6,000 Municipal bonds 3,528 8,569 — 12,097 Asset-backed securities 4,934 — — 4,934 Corporate bonds 23,062 8,661 — 31,723 Total $ 55,485 $ 17,230 $ — $ 72,715 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 June 30, 2024 and December 31, 2023. June 30, 2024 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 348,230 $ — $ — $ 348,230 Marketable securities: Agency bonds 2,449 — — 2,449 Municipal bonds 12,214 — — 12,214 Asset-backed securities — 283 — 283 Corporate bonds — 17,824 — 17,824 Total $ 362,893 $ 18,107 $ — $ 381,000 December 31, 2023 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 334,762 $ — $ — $ 334,762 Marketable securities: U.S. Treasury securities 15,373 — — 15,373 Yankee bonds 2,588 — — 2,588 Agency bonds 6,000 — — 6,000 Municipal bonds 12,097 — — 12,097 Asset-backed securities — 4,934 — 4,934 Corporate bonds — 31,723 — 31,723 Total $ 370,820 $ 36,657 $ — $ 407,477 There were no transfers of financial assets or liabilities into or out of Level 1, Level 2, or Level 3 for the three and six months ended June 30, 2024 and June 30, 2023. 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 June 30, 2024 and December 31, 2023 due to their short-term nature.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2024
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 June 30, 2024 and December 31, 2023 (in thousands): June 30, 2024 December 31, 2023 Clinical Services $ 458,782 $ 458,782 Advanced Diagnostics 63,984 63,984 Total $ 522,766 $ 522,766 Intangible assets consisted of the following (in thousands): June 30, 2024 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 70,479 $ 72,622 Developed Technology 10 - 15 310,226 65,098 245,128 Marketing Assets 4 549 445 104 Trademarks 15 31,473 6,370 25,103 Trade Name 2.5 2,584 2,584 — Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 144,976 $ 356,404 December 31, 2023 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 65,534 $ 77,567 Developed Technology 10 - 15 310,226 54,438 255,788 Marketing Assets 4 549 376 173 Trademarks 15 31,473 5,321 26,152 Trade Name 2.5 2,584 2,583 1 Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 128,252 $ 373,128 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 six months ended June 30, 2024 and 2023 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Amortization of intangibles included in cost of revenue $ 4,909 $ 4,853 $ 9,819 $ 9,706 Amortization of intangibles included in general and administrative expenses 3,452 3,930 6,904 7,860 Total amortization of intangibles $ 8,361 $ 8,783 $ 16,723 $ 17,566 The estimated amortization expense related to amortizable intangible assets for each of the following periods as of June 30, 2024 is as follows (in thousands): Remainder of 2024 $ 16,723 2025 33,343 2026 33,308 2027 32,758 2028 32,758 Thereafter 194,067 Total $ 342,957

Debt

Debt	6 Months Ended
	Jun. 30, 2024
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 March 31, 2024. 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 second quarter of 2024. 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, 2024. Based on the terms of the 2028 Convertible Notes, the holders cannot convert all or a portion of their 2028 Convertible Notes in the third quarter of 2024. The value of the 2028 Convertible Notes, if-converted, does not exceed the principal amount based on a closing stock price of $13.87 on June 28, 2024. 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 June 30, 2024. The interest expense recognized on the 2028 Convertible Notes includes $0.4 million, $0.7 million and $17,000 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the six months ended June 30, 2024. 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 June 30, 2023. The interest expense recognized on the 2028 Convertible Notes includes $0.4 million, $0.7 million and $17,000 for the contractual coupon interest, the amortization of the debt discount and the amortization of the debt issuance costs, respectively, for the six months ended June 30, 2023. 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 June 30, 2024, the estimated fair value (Level 2) of the 0.25% Convertible Senior Notes due 2028 was $269.5 million. At December 31, 2023, the estimated fair value (Level 2) of the 0.25% Convertible Senior Notes due 2028 was $262.4 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. As of June 30, 2024, the 2025 Convertible Notes were classified as current liabilities on the Consolidated Balance Sheets. 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 March 31, 2024. 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 second quarter of 2024. 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, 2024. Based on the terms of the 2025 Convertible Notes, the holders cannot convert all or a portion of their 2025 Convertible Notes in the third quarter of 2024. The value of the 2025 Convertible Notes, if-converted, does not exceed the principal amount based on a closing stock price of $13.87 on June 28, 2024. The interest expense recognized on the 2025 Convertible Notes includes $0.6 million, $0.3 million and $38,000 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 June 30, 2024. The interest expense recognized on the 2025 Convertible Notes includes $1.3 million, $0.6 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 six months ended June 30, 2024. The interest expense recognized on the 2025 Convertible Notes includes $0.6 million, $0.3 million and $37,000 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 June 30, 2023. The interest expense recognized on the 2025 Convertible Notes includes $1.3 million, $0.6 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 six months ended June 30, 2023. 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. At June 30, 2024, the estimated fair value (Level 2) of the 1.25% Convertible Senior Notes due 2025 was $195.3 million. At December 31, 2023, the estimated fair value (Level 2) of the 1.25% Convertible Senior Notes due 2025 was $197.3 million.

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Stock-Based Compensation	Stock-Based Compensation The Company recorded stock-based compensation on the Consolidated Statement of Operations for the three and six months ended June 30, 2024 and 2023 as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Cost of revenue $ 358 $ — $ 753 $ — General and administrative 7,493 5,705 14,156 10,463 Research and development 237 — 408 — Sales and marketing 753 — 1,298 — Total stock-based compensation $ 8,841 $ 5,705 $ 16,615 $ 10,463 Stock Options A summary of the stock option activity under the Company’s plans for the six months ended June 30, 2024 is as follows: Number of Weighted Average Exercise Price Outstanding at December 31, 2023 4,381,099 $ 15.87 Granted 1,529,224 $ 14.91 Exercised (294,372) $ 8.38 Forfeited (284,320) $ 14.98 Outstanding at June 30, 2024 5,331,631 $ 19.95 Exercisable at June 30, 2024 1,654,187 $ 19.95 The fair value of each stock option award granted during the six months ended June 30, 2024 was estimated as of the grant date using a Black-Scholes model with the following assumptions: Six Months Ended Expected term (in years) 5.5 - 6.5 Risk-free interest rate (%) 3.8% - 4.6% Expected volatility (%) 54.9% - 64.6% Dividend yield (%) — Weighted average grant date fair value per share $8.85 As of June 30, 2024, there was approximately $17.6 million of unrecognized stock-based compensation expense related to stock options that will be recognized over a weighted-average period of approximately 1.7 years. Restricted Stock A summary of the restricted stock activity under the Company’s plans for the six months ended June 30, 2024 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2023 1,961,919 $ 13.83 Granted 967,256 $ 14.94 Vested (397,856) $ 14.70 Forfeited (148,685) $ 14.25 Nonvested at June 30, 2024 2,382,634 $ 14.11 As of June 30, 2024, there was approximately $20.0 million of unrecognized stock-based compensation expense related to restricted stock that will be recognized over a weighted-average period of approximately 1.7 years. Performance-Based Restricted Stock Units In the six months ended June 30, 2024, the Company granted 194,257 PSUs subject to a performance condition and 194,256 PSUs subject to a market condition with an aggregated grant date fair value of approximately $3.1 million and $3.6 million, respectively. If the performance targets are achieved, the awards will vest at the end of the three-year requisite service period so long as the employee remains employed with the Company through the applicable vesting date. For PSUs subject to a performance condition, compensation cost is recognized straight-line over the requisite service period if the achievement of the performance condition is probable. As of June 30, 2024, the Company has determined it is probable that the performance condition will be met. For PSUs subject to a market condition, compensation cost is recognized straight-line over the requisite service period, regardless of when, if ever, the market condition is satisfied. A summary of the PSU activity under the Company’s plans for the six months ended June 30, 2024 is as follows: Number of Stock Units Weighted Average Grant Date Fair Value Nonvested at December 31, 2023 305,105 $ 21.83 Granted 388,513 $ 17.43 Vested — $ — Forfeited (46,534) $ 19.56 Nonvested at June 30, 2024 647,084 $ 19.35 The fair value of each PSU granted subject to a market condition during the six months ended June 30, 2024 was estimated as of the grant date using a Monte Carlo with the following assumptions: Six Months Ended Expected term (in years) 3.0 Risk-free interest rate (%) 4.5% - 4.7% Expected volatility (%) 71.3% - 72.2% Dividend yield (%) — Weighted average grant date fair value per share $17.43 As of June 30, 2024, there was approximately $9.4 million of unrecognized stock-based compensation expense related to nonvested PSUs that will be recognized over a weighted-average period of approximately 2.3 years. Modification of Stock Option and Restricted Stock In the three months ended June 30, 2024, upon the departure of an executive and in accordance with the terms of their employment agreement, in addition to the retirement of a director of the Company and with approval from the Culture and Compensation Committee of the Company’s Board of Directors, 69,049 shares of previously granted time-based vesting stock options and 41,693 shares of previously granted time-based vesting restricted stock accelerated vesting. The Company accounted for the effects of the accelerated vesting of these stock awards as modifications and recognized $0.6 million of stock-based compensation which consisted of $0.3 million and $0.3 million for the acceleration of stock options and restricted stock, respectively, within general and administrative expenses on the Consolidated Statements of Operations for the three and six months ended June 30, 2024. In the three months ended June 30, 2023, upon the departure of certain executives from the Company and in accordance with the terms of each of their respective employment agreements, 101,937 shares of previously granted time-based vesting stock options and 61,746 shares of previously granted time-based vesting restricted stock accelerated vesting. The Company accounted for the effects of the accelerated vesting of these stock awards as modifications, and recognized $0.9 million of stock-based compensation which consisted of $0.3 million and $0.6 million for the acceleration of stock options and restricted stock, respectively, within general and administrative expenses on the Consolidated Statements of Operations for the three and six months ended June 30, 2023.

Revenue Recognition

Revenue Recognition	6 Months Ended
	Jun. 30, 2024
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) Advanced Diagnostics. 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 Advanced Diagnostics 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 an 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. Advanced Diagnostics Revenue The Company’s Advanced Diagnostics segment generally enters into contracts with pharmaceutical and biotech customers as well as other CROs to provide research and clinical trial services. Such services also include validation studies and assay development. The Company records revenue on a unit-of-service basis based on the number of units completed towards the satisfaction of a performance obligation. In addition, certain contracts include upfront fees and the revenue for those contracts is recognized over time as services are performed. Additional offerings within the Advanced Diagnostics portfolio includes Informatics, which involves the licensing of de-identified data to pharmaceutical and biotech customers in the form of either retrospective records or prospective deliveries of data. Informatics revenue is recognized at a point in time upon delivery of retrospective data or over time for prospective data feeds. The Company negotiates billing schedules and payment terms on a contract-by-contract basis, and contract terms generally provide for payments based on a unit-of-service arrangement. 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, Advanced Diagnostics incurs sales commissions in the process of obtaining contracts with customers. Sales commissions that are payable upon contract award are recognized as assets and amortized over the expected contract term. The amortization of commission expense is based on the weighted average contract duration for all commissionable awards in the respective business in which the commission expense is paid, which approximates the period over which goods and services are transferred to the customer. For offerings with primarily short-term contracts, such as Informatics, the Company applies the practical expedient which allows costs to obtain a contract to be expensed when incurred, if the amortization period of the assets that would otherwise have been recognized is one year or less. Contract assets and capitalized commissions are included in other current assets and other assets on the Consolidated Balance Sheets. 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): June 30, 2024 December 31, 2023 Current contract assets (1) $ — $ 37 Long-term contract assets (2) — — Total contract assets $ — $ 37 Current capitalized commissions (1) $ 711 $ 935 Long-term capitalized commissions (2) 171 53 Total capitalized commissions $ 882 $ 988 Current contract liabilities $ 972 $ 2,130 Long-term contract liabilities (3) 349 — Total contract liabilities $ 1,321 $ 2,130 (1) Recorded within other current assets on the Consolidated Balance Sheets. (2) Recorded within other assets on the Consolidated Balance Sheets. (3) Recorded within other long-term liabilities on the Consolidated Balance Sheets. Revenue recognized for the three and six months ended June 30, 2024 related to contract liability balances outstanding at the beginning of the period was $0.3 million and $1.4 million, respectively. Revenue recognized for the three and six months ended June 30, 2023 related to contract liability balances outstanding at the beginning of the period was $1.7 million and $3.5 million, respectively. Amortization of capitalized commissions for the three and six months ended June 30, 2024 was $0.2 million and $0.5 million, respectively. Amortization of capitalized commissions for the three and six months ended June 30, 2023 was $0.3 million and $0.5 million, respectively. Disaggregation of Revenue The Company considered various factors for both its Clinical Services and Advanced Diagnostics 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. Advanced Diagnostics 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, Advanced Diagnostics revenue is not further disaggregated. The following table details the disaggregation of revenue for both the Clinical Services and Advanced Diagnostics Segments (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Clinical Services Client direct billing $ 95,191 $ 83,176 $ 185,674 $ 159,999 Commercial insurance 24,843 21,695 48,447 43,050 Medicare and Medicaid 21,197 18,196 41,566 34,783 Self-Pay 157 89 236 193 Total Clinical Services $ 141,388 $ 123,156 $ 275,923 $ 238,025 Advanced Diagnostics 23,114 23,761 44,819 46,112 Total Revenue $ 164,502 $ 146,917 $ 320,742 $ 284,137

Restructuring

Restructuring	6 Months Ended
	Jun. 30, 2024
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring In 2022, the Company embarked on a restructuring program to improve execution and drive efficiency across the organization. This program is a framework for identifying, prioritizing and executing operational improvements. Restructuring charges incurred consist of severance and other employee costs, costs for optimizing the Company’s geographic presence (“Facility Footprint Optimization”), and consulting and other costs. The following table summarizes the changes in the Company’s accrued restructuring balance (in thousands): Severance and Other Employee Costs Facility Footprint Optimization Consulting and Other Costs Total Balance as of December 31, 2023 $ 687 $ 1,389 $ 537 $ 2,613 Restructuring charges incurred 697 964 747 2,408 Impairment of facility related assets — (10) — (10) Cash payments and other adjustments (1) (771) (1,796) (1,125) (3,692) Balance as of March 31, 2024 $ 613 $ 547 $ 159 $ 1,319 Restructuring charges incurred 703 650 111 1,464 Impairment of facility related assets — 80 — 80 Cash payments and other adjustments (1) (575) (957) (116) (1,648) Balance as of June 30, 2024 $ 741 $ 320 $ 154 $ 1,215 Current liabilities $ 1,215 Long-term liabilities — $ 1,215 (1) Other adjustments include non-cash asset charges related to Facility Footprint Optimization costs. The Company continued this restructuring program in 2024 and expects to incur additional restructuring charges of approximately $1.7 million. The Company estimates these additional restructuring charges to be comprised of approximately $0.3 million in severance and other employee costs, $1.2 million of Facility Footprint Optimization costs, and $0.2 million of consulting and other costs.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2024
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, commonly defined as a three-year cumulative loss position, is a significant piece of negative evidence that is difficult to overcome. As of June 30, 2024, the Company’s U.S. operations are in a three-year cumulative loss position. Management determined that sufficient objectively verifiable positive evidence does 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 six months ended June 30, 2024, includes the unfavorable impact of a partial valuation allowance against the majority of the Company’s forecasted U.S. net operating loss and tax credit carryforwards. As of June 30, 2024, the Company’s U.K. operations are in a three-year cumulative loss position. The reversal of U.K. deferred tax liabilities will provide a source of realization to support a portion of the U.K. deferred tax assets, and therefore a partial valuation has been established for those deferred tax assets. Accordingly, the Company’s estimated annual effective tax rate applied to the Company’s pre-tax loss for the three and six months ended June 30, 2024 includes the favorable impact of recognizing a component of the U.K. benefit.

Net Loss Per Share

Net Loss Per Share	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
Net Loss Per Share	Net Loss 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 shares of common stock outstanding for the period. Diluted EPS reflects the potential dilution that could occur if stock options were exercised, stock awards vested 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 June 30, Six Months Ended June 30, 2024 2023 2024 2023 NET LOSS $ (18,642) $ (24,331) $ (45,703) $ (55,126) Basic weighted average shares outstanding 126,405 125,356 126,257 125,192 Diluted weighted average shares outstanding 126,405 125,356 126,257 125,192 Basic net loss per share $ (0.15) $ (0.19) $ (0.36) $ (0.44) Diluted net loss per share $ (0.15) $ (0.19) $ (0.36) $ (0.44) The following potential dilutive shares were excluded from the calculation of diluted net loss per share because their effect would be anti-dilutive (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Stock options 406 574 477 474 Restricted stock awards 1,012 1,016 1,026 987 2025 Convertible Notes 5,538 5,538 5,538 5,538 2028 Convertible Notes 5,215 5,215 5,215 5,215 In addition, 647,084 shares of PSU awards are excluded from the computation of diluted EPS for the three and six months ended June 30, 2024 as the contingency had not been satisfied. 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 was excluded from the calculation of diluted net loss per share in the three and six months ended June 30, 2024 as the Company’s common stock closing price of $13.87 on June 28, 2024 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	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Legal Proceedings On January 20, 2021, Natera, Inc. filed a patent infringement complaint against the Company’s subsidiary Inivata Limited and its subsidiary Inivata, Inc. in U.S. District Court for the district of Delaware, alleging Inivata’s InVisionFirst®-Lung cancer diagnostic test of infringing two patents. Natera then filed a second patent infringement complaint on December 20, 2022 against Inivata Limited and Inivata, Inc. alleging that RaDaR ® minimal residual disease test infringes one patent. The case is in discovery and the jury trial has been scheduled for October 6, 2025. On March 6, 2024, the parties stipulated to stay both Delaware cases until the North Carolina litigation is resolved. On March 7, 2024, the district court judge in Delaware ordered the cases stayed. On July 28, 2023, Natera filed a complaint in the Middle District of North Carolina alleging NeoGenomics' RaDaR ® test infringes on two patents. On July 31, 2023, Natera moved for a preliminary injunction. On December 27, 2023, the district court issued a preliminary injunction against RaDaR ® . Natera posted a $10 million bond with the court on January 12, 2024. The court's initial determination was that Natera, Inc. demonstrated a likelihood that products using RaDaR ® technology infringe one Natera, Inc. patent. The order specifically allows patients already using RaDaR ® to continue their use. In addition, the order explicitly allows research projects and studies that are in progress, as well as clinical trials that are in progress or have been approved, to continue. On December 28, 2023, NeoGenomics appealed the preliminary injunction to the Federal Circuit. The appeal was docketed at the Federal Circuit on January 4, 2024. On February 5, 2024, NeoGenomics filed an Emergency Motion to Stay the Preliminary Injunction pending Appeal and a Motion to Expedite the appeal. The Federal Circuit granted expedited briefing of the appeal and heard oral arguments on March 29, 2024. On July 12, 2024, the Federal Circuit affirmed the injunction. The infringement case is in discovery and the jury trial has been scheduled for March 10, 2025. The Company has filed two inter partes review petitions before the Patent Trial and Appeal Board (“PTAB”) in the United States Patent and Trademark Office seeking a determination that the two patents asserted against NeoGenomics in the North Carolina action are unpatentable in view of prior art. On June 21, 2024, the PTAB denied institution for one of the asserted patents. The PTAB has not yet determined whether to institute trial in the inter partes review of the other asserted patent. The Company believes that it has good and substantial defenses to the claims alleged in these suits, but there is no guarantee that the Company will prevail. At the time of filing the outcome of these matters is not estimable or probable. On December 16, 2022, a purported shareholder class action captioned Daniel Goldenberg v. NeoGenomics, Inc., Douglas VanOort, Mark Mallon, Kathryn McKenzie, and William Bonello was filed in the United States District Court for the Southern District of New York, naming the Company and certain of the Company’s current and former officers as defendants. This lawsuit was filed by a stockholder who claims to be suing on behalf of anyone who purchased or otherwise acquired the Company’s securities between February 27, 2020 and April 26, 2022. The lawsuit alleges that material misrepresentations and/or omissions of material fact were made in the Company’s public disclosures in violation of Sections 10(b) and 20(a) of the Exchange Act and Rule 10b-5 promulgated thereunder. The alleged improper disclosures relate to statements regarding the Company’s menu of tests, business operations and compliance with health care laws and regulations. The plaintiff seeks unspecified monetary damages on behalf of the putative class and an award of costs and expenses, including attorney’s fees and expert fees. On April 27, 2023, a shareholder of the Company filed a shareholder derivative action on behalf of the Company captioned Puskarich v. VanOort, et al. in Clark County Nevada, naming certain of the Company’s current and former officers and directors as defendants. The allegations are substantially similar to the allegations asserted in the Goldenberg action. Substantially similar shareholder derivative actions were subsequently filed in Lee County, Florida and in the United States District Court for the Southern District of New York, captioned Wong v. VanOort, et al. and Mellema v. VanOort, et al., respectively. The Company believes that it has valid defenses to the claims alleged in the lawsuits, but there is no guarantee that the Company will prevail. At the time of filing the outcome of these matters are not estimable or probable. Regulatory Matter With the assistance of outside counsel, the Company voluntarily conducted an internal investigation that focused 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 interactions with regulatory authorities and the Company’s related review of this matter are ongoing. The Company has a reserve of $11.2 million in other long-term liabilities as of June 30, 2024 and December 31, 2023 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 internal investigation and ongoing 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, exclusion from participation in federal healthcare programs 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	6 Months Ended
	Jun. 30, 2024
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company has Advanced Diagnostics contracts with HOOKIPA Pharma, Inc., an entity with whom a director of the Company, Michael A. Kelly, was a director until April 2023. In connection with these contracts, the Company recognized $0.2 million of revenue in the Consolidated Statements of Operations for the six months ended June 30, 2023. Revenue recognized in connection with these contracts for the three months ended June 30, 2023 was immaterial.

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
Segment Information	Segment Information The Company recognizes revenue under two reportable segments, (1) Clinical Services and (2) Advanced Diagnostics. 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 Advanced Diagnostics 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 segment information for the three and six months ended June 30, 2024, and 2023 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net revenues: Clinical Services $ 141,388 $ 123,156 $ 275,923 $ 238,025 Advanced Diagnostics 23,114 23,761 44,819 46,112 Total revenue 164,502 146,917 320,742 284,137 Cost of revenue: Clinical Services (1) 78,094 71,746 154,938 139,038 Advanced Diagnostics (2) 13,914 15,280 27,841 30,394 Total cost of revenue 92,008 87,026 182,779 169,432 Gross Profit: Clinical Services 63,294 51,410 120,985 98,987 Advanced Diagnostics 9,200 8,481 16,978 15,718 Total gross profit $ 72,494 $ 59,891 $ 137,963 $ 114,705 (1) Clinical Services cost of revenue adjustments for the three months ended June 30, 2024 includes $4.3 million of amortization of acquired intangible assets and $0.2 million of stock-based compensation. Clinical Services cost of revenue adjustments for the three months ended June 30, 2023 includes $4.3 million of amortization of acquired intangible assets. Clinical Services cost of revenue adjustments for the six months ended June 30, 2024 includes $8.6 million of amortization of acquired intangible assets and $0.5 million of stock-based compensation. Clinical Services cost of revenue adjustments for the six months ended June 30, 2023 includes $8.5 million of amortization of acquired intangible assets. There were no stock-based compensation amounts recorded for the three and six months ended June 30, 2023. (2) Advanced Diagnostics cost of revenue adjustments for the three months ended June 30, 2024 includes $0.6 million of amortization of acquired intangible assets and $0.1 million of stock-based compensation. Advanced Diagnostics cost of revenue adjustments for the three months ended June 30, 2023 includes $0.6 million of amortization of acquired intangible assets. Advanced Diagnostics cost of revenue adjustments for the six months ended June 30, 2024 includes $1.2 million of amortization of acquired intangible assets and $0.2 million of stock-based compensation. Advanced Diagnostics cost of revenue adjustments for the six months ended June 30, 2023 includes $1.2 million of amortization of acquired intangible assets. There were no stock-based compensation amounts recorded for the three and six months ended June 30, 2023.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
NET LOSS	$ (18,642)	$ (27,061)	$ (24,331)	$ (30,795)	$ (45,703)	$ (55,126)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2024
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 generally accepted accounting principles in the United States (“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, 2023, 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, impairment analysis of goodwill, and restructuring reserves. 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.
Sales and Marketing Expenses	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 six months ended June 30, 2024 and 2023.
Restructuring charges	Restructuring charges
Accounting Pronouncements Pending Adoption	Accounting Pronouncements Pending Adoption In December 2023, the FASB issued ASU No. 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures. This update requires entities to consistently categorize and provide greater disaggregation of information in the rate reconciliation and to further disaggregate income taxes paid by jurisdiction. ASU 2023-09 is effective for fiscal years beginning after December 15, 2024, with early adoption permitted. ASU 2023-07 may be applied retrospectively or prospectively. The Company is currently evaluating the impact of this standard on its annual disclosures. In November 2023, the FASB issued ASU No. 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures. This update requires entities to disclose significant segment expenses by reportable segment if they are regularly provided to the Chief Operating Decision Maker (CODM) and included in each reported measure of segment profit or loss and requires disclosure of other segment items by reportable segment and a description of its composition. ASU 2023-07 is effective for fiscal years beginning after December 15, 2023 and interim periods within fiscal years beginning after December 15, 2024, with early adoption permitted. ASU 2023-07 should be applied retrospectively to all prior periods presented in the financial statements. The Company is currently evaluating the impact of this standard on its annual disclosures.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2024
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 June 30, 2024 and December 31, 2023. June 30, 2024 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: Agency bonds 2,481 — (32) 2,449 Municipal bonds 12,621 — (407) 12,214 Asset-backed securities 283 — — 283 Corporate bonds 18,221 — (397) 17,824 Total $ 33,606 $ — $ (836) $ 32,770 December 31, 2023 (in thousands) Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Financial Assets: Short-term marketable securities: U.S. Treasury securities $ 15,437 $ — $ (64) $ 15,373 Yankee bonds 2,601 — (13) 2,588 Agency bonds 6,056 — (56) 6,000 Municipal bonds 12,694 — (597) 12,097 Asset-backed securities 4,971 — (37) 4,934 Corporate bonds 32,442 — (719) 31,723 Total $ 74,201 $ — $ (1,486) $ 72,715
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 June 30, 2024 and December 31, 2023. June 30, 2024 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: Agency bonds 2,449 — — 2,449 Municipal bonds 6,454 5,760 — 12,214 Asset-backed securities 283 — — 283 Corporate bonds 14,979 2,845 — 17,824 Total $ 24,165 $ 8,605 $ — $ 32,770 December 31, 2023 (in thousands) One Year or Less Over One Year Through Five Years Over Five Years Total Financial Assets: Marketable Securities: U.S. Treasury securities $ 15,373 $ — $ — $ 15,373 Yankee bonds 2,588 — — 2,588 Agency bonds 6,000 — — 6,000 Municipal bonds 3,528 8,569 — 12,097 Asset-backed securities 4,934 — — 4,934 Corporate bonds 23,062 8,661 — 31,723 Total $ 55,485 $ 17,230 $ — $ 72,715
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 June 30, 2024 and December 31, 2023. June 30, 2024 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 348,230 $ — $ — $ 348,230 Marketable securities: Agency bonds 2,449 — — 2,449 Municipal bonds 12,214 — — 12,214 Asset-backed securities — 283 — 283 Corporate bonds — 17,824 — 17,824 Total $ 362,893 $ 18,107 $ — $ 381,000 December 31, 2023 (in thousands) Level 1 Level 2 Level 3 Total Financial Assets: Cash equivalents: Money market funds $ 334,762 $ — $ — $ 334,762 Marketable securities: U.S. Treasury securities 15,373 — — 15,373 Yankee bonds 2,588 — — 2,588 Agency bonds 6,000 — — 6,000 Municipal bonds 12,097 — — 12,097 Asset-backed securities — 4,934 — 4,934 Corporate bonds — 31,723 — 31,723 Total $ 370,820 $ 36,657 $ — $ 407,477

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The following table summarizes the carrying amounts of goodwill by segment at June 30, 2024 and December 31, 2023 (in thousands): June 30, 2024 December 31, 2023 Clinical Services $ 458,782 $ 458,782 Advanced Diagnostics 63,984 63,984 Total $ 522,766 $ 522,766
Schedule of Classes of Intangible Assets	Intangible assets consisted of the following (in thousands): June 30, 2024 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 70,479 $ 72,622 Developed Technology 10 - 15 310,226 65,098 245,128 Marketing Assets 4 549 445 104 Trademarks 15 31,473 6,370 25,103 Trade Name 2.5 2,584 2,584 — Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 144,976 $ 356,404 December 31, 2023 Amortization Cost Accumulated Net Customer Relationships 7 - 15 $ 143,101 $ 65,534 $ 77,567 Developed Technology 10 - 15 310,226 54,438 255,788 Marketing Assets 4 549 376 173 Trademarks 15 31,473 5,321 26,152 Trade Name 2.5 2,584 2,583 1 Trademark - Indefinite lived — 13,447 — 13,447 Total $ 501,380 $ 128,252 $ 373,128
Schedule of Intangible Asset Amortization Expense	The following table summarizes the amortization expense for the three and six months ended June 30, 2024 and 2023 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Amortization of intangibles included in cost of revenue $ 4,909 $ 4,853 $ 9,819 $ 9,706 Amortization of intangibles included in general and administrative expenses 3,452 3,930 6,904 7,860 Total amortization of intangibles $ 8,361 $ 8,783 $ 16,723 $ 17,566
Schedule of Estimated Amortization Expense	The estimated amortization expense related to amortizable intangible assets for each of the following periods as of June 30, 2024 is as follows (in thousands): Remainder of 2024 $ 16,723 2025 33,343 2026 33,308 2027 32,758 2028 32,758 Thereafter 194,067 Total $ 342,957

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2024
Equity [Abstract]
Share-Based Payment Arrangement, Expensed and Capitalized, Amount	The Company recorded stock-based compensation on the Consolidated Statement of Operations for the three and six months ended June 30, 2024 and 2023 as follows (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Cost of revenue $ 358 $ — $ 753 $ — General and administrative 7,493 5,705 14,156 10,463 Research and development 237 — 408 — Sales and marketing 753 — 1,298 — Total stock-based compensation $ 8,841 $ 5,705 $ 16,615 $ 10,463
Schedule of Stock Option Activity	A summary of the stock option activity under the Company’s plans for the six months ended June 30, 2024 is as follows: Number of Weighted Average Exercise Price Outstanding at December 31, 2023 4,381,099 $ 15.87 Granted 1,529,224 $ 14.91 Exercised (294,372) $ 8.38 Forfeited (284,320) $ 14.98 Outstanding at June 30, 2024 5,331,631 $ 19.95 Exercisable at June 30, 2024 1,654,187 $ 19.95
Schedule of Fair Value of Each Stock Option Award Granted	The fair value of each stock option award granted during the six months ended June 30, 2024 was estimated as of the grant date using a Black-Scholes model with the following assumptions: Six Months Ended Expected term (in years) 5.5 - 6.5 Risk-free interest rate (%) 3.8% - 4.6% Expected volatility (%) 54.9% - 64.6% Dividend yield (%) — Weighted average grant date fair value per share $8.85
Schedule of Restricted Stock Activity	A summary of the restricted stock activity under the Company’s plans for the six months ended June 30, 2024 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2023 1,961,919 $ 13.83 Granted 967,256 $ 14.94 Vested (397,856) $ 14.70 Forfeited (148,685) $ 14.25 Nonvested at June 30, 2024 2,382,634 $ 14.11 A summary of the PSU activity under the Company’s plans for the six months ended June 30, 2024 is as follows: Number of Stock Units Weighted Average Grant Date Fair Value Nonvested at December 31, 2023 305,105 $ 21.83 Granted 388,513 $ 17.43 Vested — $ — Forfeited (46,534) $ 19.56 Nonvested at June 30, 2024 647,084 $ 19.35
Schedule of Fair Value of PSU Award Granted	The fair value of each PSU granted subject to a market condition during the six months ended June 30, 2024 was estimated as of the grant date using a Monte Carlo with the following assumptions: Six Months Ended Expected term (in years) 3.0 Risk-free interest rate (%) 4.5% - 4.7% Expected volatility (%) 71.3% - 72.2% Dividend yield (%) — Weighted average grant date fair value per share $17.43

Revenue Recognition (Tables)

Revenue Recognition (Tables)	6 Months Ended
	Jun. 30, 2024
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): June 30, 2024 December 31, 2023 Current contract assets (1) $ — $ 37 Long-term contract assets (2) — — Total contract assets $ — $ 37 Current capitalized commissions (1) $ 711 $ 935 Long-term capitalized commissions (2) 171 53 Total capitalized commissions $ 882 $ 988 Current contract liabilities $ 972 $ 2,130 Long-term contract liabilities (3) 349 — Total contract liabilities $ 1,321 $ 2,130 (1) Recorded within other current assets on the Consolidated Balance Sheets. (2) Recorded within other assets on the Consolidated Balance Sheets. (3) Recorded within other long-term liabilities on the Consolidated Balance Sheets.
Schedule of Disaggregation of Revenue	The following table details the disaggregation of revenue for both the Clinical Services and Advanced Diagnostics Segments (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Clinical Services Client direct billing $ 95,191 $ 83,176 $ 185,674 $ 159,999 Commercial insurance 24,843 21,695 48,447 43,050 Medicare and Medicaid 21,197 18,196 41,566 34,783 Self-Pay 157 89 236 193 Total Clinical Services $ 141,388 $ 123,156 $ 275,923 $ 238,025 Advanced Diagnostics 23,114 23,761 44,819 46,112 Total Revenue $ 164,502 $ 146,917 $ 320,742 $ 284,137

Restructuring (Tables)

Restructuring (Tables)	6 Months Ended
	Jun. 30, 2024
Restructuring and Related Activities [Abstract]
Schedule of Accrued Restructuring	The following table summarizes the changes in the Company’s accrued restructuring balance (in thousands): Severance and Other Employee Costs Facility Footprint Optimization Consulting and Other Costs Total Balance as of December 31, 2023 $ 687 $ 1,389 $ 537 $ 2,613 Restructuring charges incurred 697 964 747 2,408 Impairment of facility related assets — (10) — (10) Cash payments and other adjustments (1) (771) (1,796) (1,125) (3,692) Balance as of March 31, 2024 $ 613 $ 547 $ 159 $ 1,319 Restructuring charges incurred 703 650 111 1,464 Impairment of facility related assets — 80 — 80 Cash payments and other adjustments (1) (575) (957) (116) (1,648) Balance as of June 30, 2024 $ 741 $ 320 $ 154 $ 1,215 Current liabilities $ 1,215 Long-term liabilities — $ 1,215 (1) Other adjustments include non-cash asset charges related to Facility Footprint Optimization costs.

Net Loss Per Share (Tables)

Net Loss Per Share (Tables)	6 Months Ended
	Jun. 30, 2024
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 June 30, Six Months Ended June 30, 2024 2023 2024 2023 NET LOSS $ (18,642) $ (24,331) $ (45,703) $ (55,126) Basic weighted average shares outstanding 126,405 125,356 126,257 125,192 Diluted weighted average shares outstanding 126,405 125,356 126,257 125,192 Basic net loss per share $ (0.15) $ (0.19) $ (0.36) $ (0.44) Diluted net loss per share $ (0.15) $ (0.19) $ (0.36) $ (0.44)
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 per share because their effect would be anti-dilutive (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Stock options 406 574 477 474 Restricted stock awards 1,012 1,016 1,026 987 2025 Convertible Notes 5,538 5,538 5,538 5,538 2028 Convertible Notes 5,215 5,215 5,215 5,215

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
Schedule of Segment Information	The following table summarizes segment information for the three and six months ended June 30, 2024, and 2023 (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net revenues: Clinical Services $ 141,388 $ 123,156 $ 275,923 $ 238,025 Advanced Diagnostics 23,114 23,761 44,819 46,112 Total revenue 164,502 146,917 320,742 284,137 Cost of revenue: Clinical Services (1) 78,094 71,746 154,938 139,038 Advanced Diagnostics (2) 13,914 15,280 27,841 30,394 Total cost of revenue 92,008 87,026 182,779 169,432 Gross Profit: Clinical Services 63,294 51,410 120,985 98,987 Advanced Diagnostics 9,200 8,481 16,978 15,718 Total gross profit $ 72,494 $ 59,891 $ 137,963 $ 114,705 (1) Clinical Services cost of revenue adjustments for the three months ended June 30, 2024 includes $4.3 million of amortization of acquired intangible assets and $0.2 million of stock-based compensation. Clinical Services cost of revenue adjustments for the three months ended June 30, 2023 includes $4.3 million of amortization of acquired intangible assets. Clinical Services cost of revenue adjustments for the six months ended June 30, 2024 includes $8.6 million of amortization of acquired intangible assets and $0.5 million of stock-based compensation. Clinical Services cost of revenue adjustments for the six months ended June 30, 2023 includes $8.5 million of amortization of acquired intangible assets. There were no stock-based compensation amounts recorded for the three and six months ended June 30, 2023. (2) Advanced Diagnostics cost of revenue adjustments for the three months ended June 30, 2024 includes $0.6 million of amortization of acquired intangible assets and $0.1 million of stock-based compensation. Advanced Diagnostics cost of revenue adjustments for the three months ended June 30, 2023 includes $0.6 million of amortization of acquired intangible assets. Advanced Diagnostics cost of revenue adjustments for the six months ended June 30, 2024 includes $1.2 million of amortization of acquired intangible assets and $0.2 million of stock-based compensation. Advanced Diagnostics cost of revenue adjustments for the six months ended June 30, 2023 includes $1.2 million of amortization of acquired intangible assets. There were no stock-based compensation amounts recorded for the three and six months ended June 30, 2023.

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Amortized Cost (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	$ 33,606,000		$ 33,606,000		$ 74,201,000
Gross Unrealized Gains	0		0		0
Gross Unrealized Losses	(836,000)		(836,000)		(1,486,000)
Fair Value	32,770,000		32,770,000		72,715,000
Accrued interest receivable	1,500,000		1,500,000		1,700,000
Realized gains (losses) on marketable securities	0	$ 0	0	$ 0
U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost					15,437,000
Gross Unrealized Gains					0
Gross Unrealized Losses					(64,000)
Fair Value					15,373,000
Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost					2,601,000
Gross Unrealized Gains					0
Gross Unrealized Losses					(13,000)
Fair Value					2,588,000
Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	2,481,000		2,481,000		6,056,000
Gross Unrealized Gains	0		0		0
Gross Unrealized Losses	(32,000)		(32,000)		(56,000)
Fair Value	2,449,000		2,449,000		6,000,000
Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	12,621,000		12,621,000		12,694,000
Gross Unrealized Gains	0		0		0
Gross Unrealized Losses	(407,000)		(407,000)		(597,000)
Fair Value	12,214,000		12,214,000		12,097,000
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	283,000		283,000		4,971,000
Gross Unrealized Gains	0		0		0
Gross Unrealized Losses	0		0		(37,000)
Fair Value	283,000		283,000		4,934,000
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Amortized Cost	18,221,000		18,221,000		32,442,000
Gross Unrealized Gains	0		0		0
Gross Unrealized Losses	(397,000)		(397,000)		(719,000)
Fair Value	$ 17,824,000		$ 17,824,000		$ 31,723,000

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value by Contractual Maturity (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	$ 24,165	$ 55,485
Over One Year Through Five Years	8,605	17,230
Over Five Years	0	0
Total	32,770	72,715
U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less		15,373
Over One Year Through Five Years		0
Over Five Years		0
Total		15,373
Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less		2,588
Over One Year Through Five Years		0
Over Five Years		0
Total		2,588
Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	2,449	6,000
Over One Year Through Five Years	0	0
Over Five Years	0	0
Total	2,449	6,000
Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	6,454	3,528
Over One Year Through Five Years	5,760	8,569
Over Five Years	0	0
Total	12,214	12,097
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	283	4,934
Over One Year Through Five Years	0	0
Over Five Years	0	0
Total	283	4,934
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
One Year or Less	14,979	23,062
Over One Year Through Five Years	2,845	8,661
Over Five Years	0	0
Total	$ 17,824	$ 31,723

Fair Value Measurements - Asset

Fair Value Measurements - Assets Measured on Recurring Basis (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	$ 32,770	$ 72,715
U.S. Treasury securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value		15,373
Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value		2,588
Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	2,449	6,000
Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	12,214	12,097
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	283	4,934
Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	17,824	31,723
Fair Value, Recurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	381,000	407,477
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		15,373
Fair Value, Recurring | Yankee bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value		2,588
Fair Value, Recurring | Agency bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	2,449	6,000
Fair Value, Recurring | Municipal bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	12,214	12,097
Fair Value, Recurring | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	283	4,934
Fair Value, Recurring | Corporate bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	17,824	31,723
Fair Value, Recurring | Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	348,230	334,762
Fair Value, Recurring | Level 1
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	362,893	370,820
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		15,373
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		2,588
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	2,449	6,000
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	12,214	12,097
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 1 | Money market funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Cash equivalents:	348,230	334,762
Fair Value, Recurring | Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	18,107	36,657
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
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
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 | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities, at fair value	283	4,934
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	17,824	31,723
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 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total	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
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
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 | 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
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

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Schedule of Goodwill (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Goodwill [Line Items]
Goodwill	$ 522,766	$ 522,766
Clinical Services
Goodwill [Line Items]
Goodwill	458,782	458,782
Advanced Diagnostics
Goodwill [Line Items]
Goodwill	$ 63,984	$ 63,984

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Classes of Intangible Assets (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	$ 144,976	$ 128,252
Total	342,957
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Total cost of intangibles	501,380	501,380
Accumulated Amortization	144,976	128,252
Intangible assets, net	356,404	373,128
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Cost	143,101	143,101
Accumulated Amortization	70,479	65,534
Total	72,622	77,567
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Accumulated Amortization	70,479	65,534
Developed Technology
Finite-Lived Intangible Assets [Line Items]
Cost	310,226	310,226
Accumulated Amortization	65,098	54,438
Total	245,128	255,788
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Accumulated Amortization	$ 65,098	$ 54,438
Marketing Assets
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	4 years	4 years
Cost	$ 549	$ 549
Accumulated Amortization	445	376
Total	104	173
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Accumulated Amortization	$ 445	$ 376
Trademarks
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	15 years	15 years
Cost	$ 31,473	$ 31,473
Accumulated Amortization	6,370	5,321
Total	25,103	26,152
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Accumulated Amortization	$ 6,370	$ 5,321
Trade Name
Finite-Lived Intangible Assets [Line Items]
Amortization Period (years)	2 years 6 months	2 years 6 months
Cost	$ 2,584	$ 2,584
Accumulated Amortization	2,584	2,583
Total	0	1
Intangible Assets, Net (Excluding Goodwill) [Abstract]
Accumulated Amortization	$ 2,584	$ 2,583
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
Trademarks
Indefinite-Lived Intangible Assets [Line Items]
Trademark - Indefinite lived	$ 13,447	$ 13,447

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Schedule of Amortization Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Finite-Lived Intangible Assets [Line Items]
Total amortization of intangibles	$ 8,361	$ 8,783	$ 16,723	$ 17,566
Amortization of intangibles included in cost of revenue
Finite-Lived Intangible Assets [Line Items]
Total amortization of intangibles	4,909	4,853	9,819	9,706
Amortization of intangibles included in general and administrative expenses
Finite-Lived Intangible Assets [Line Items]
Total amortization of intangibles	$ 3,452	$ 3,930	$ 6,904	$ 7,860

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Estimated Amortization Expense (Details) $ in Thousands	Jun. 30, 2024 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2024	$ 16,723
2025	33,343
2026	33,308
2027	32,758
2028	32,758
Thereafter	194,067
Total	$ 342,957

Debt (Details)

Debt (Details) - Convertible Debt	3 Months Ended				6 Months Ended
	Jun. 30, 2024 USD ($) day $ / shares	Mar. 31, 2024 day	Jun. 30, 2023 USD ($)	Mar. 31, 2023 day	Jun. 30, 2024 USD ($) $ / shares	Jun. 30, 2023 USD ($)	Jun. 28, 2024 $ / shares	Dec. 31, 2023 USD ($)	Jan. 11, 2021 USD ($)	May 04, 2020 USD ($)
2028 Convertible Notes
Line of Credit Facility [Line Items]
Debt instrument, face amount									$ 345,000,000
Stated interest rate (as a percent)	0.25%				0.25%			0.25%	0.25%
Convertible notes, conversion price (in dollars per share) | $ / shares	$ 13.87				$ 13.87		$ 13.87
Interest expense, contractual coupon interest	$ 200,000		$ 200,000		$ 400,000	$ 400,000
Interest expense, accretion of debt discount	400,000		400,000		700,000	700,000
Interest expense, amortization of debt issuance costs	8,500		8,500		$ 17,000	17,000
Effective interest rate on convertible notes (as a percent)					0.70%
2028 Convertible Notes | Level 2
Line of Credit Facility [Line Items]
Estimated fair value of debt	$ 269,500,000				$ 269,500,000			$ 262,400,000
2028 Convertible 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
2025 Convertible 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%
Interest expense, contractual coupon interest	$ 600,000		600,000		$ 1,300,000	1,300,000
Interest expense, accretion of debt discount	300,000		300,000		600,000	600,000
Interest expense, amortization of debt issuance costs	38,000		$ 37,000		$ 100,000	$ 100,000
Effective interest rate on convertible notes (as a percent)					1.96%
2025 Convertible Notes | Level 2
Line of Credit Facility [Line Items]
Estimated fair value of debt	$ 195,300,000				$ 195,300,000			$ 197,300,000
2025 Convertible 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 - Sche

Stock-Based Compensation - Schedule of Stock Based Compensation (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	$ 8,841	$ 5,705	$ 16,615	$ 10,463
Cost of revenue
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	358	0	753	0
General and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	7,493	5,705	14,156	10,463
Research and development
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	237	0	408	0
Sales and marketing
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total stock-based compensation	$ 753	$ 0	$ 1,298	$ 0

Stock-Based Compensation - Narr

Stock-Based Compensation - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Incremental stock-based compensation for accelerated vesting	$ 0.6	$ 0.9
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation cost, option	$ 17.6		$ 17.6
Unrecognized share-based compensation expense, weighted-average recognition period (in years)			1 year 8 months 12 days
Stock options | Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting (in shares)	69,049	101,937
Incremental stock-based compensation for accelerated vesting	$ 0.3	$ 0.3
Restricted stock awards
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized share-based compensation expense, weighted-average recognition period (in years)			1 year 8 months 12 days
Unrecognized stock-based compensation cost, non-option	$ 20		$ 20
Granted (in shares)			967,256
Restricted stock awards | Executive Officer
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Accelerated vesting (in shares)	41,693	61,746
Incremental stock-based compensation for accelerated vesting	$ 0.3	$ 0.6
Performance Shares Subject To Performance Condition
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			194,257
Granted in period, fair value			$ 3.1
Requisite service period (in years)			3 years
Performance Shares Subject To Market Condition
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)			194,256
Granted in period, fair value			$ 3.6
PSU
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized share-based compensation expense, weighted-average recognition period (in years)			2 years 3 months 18 days
Unrecognized stock-based compensation cost, non-option	$ 9.4		$ 9.4
Granted (in shares)			388,513

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Stock Option Activity (Details) - $ / shares	6 Months Ended
	Jun. 30, 2024
Number of Shares
Beginning balance (in shares)	4,381,099
Granted (in shares)	1,529,224
Exercised (in shares)	(294,372)
Forfeited (in shares)	(284,320)
Ending balance (in shares)	5,331,631
Exercisable at end of period (in shares)	1,654,187
Weighted Average Exercise Price
Beginning balance (in dollars per share)	$ 15.87
Granted (in dollars per share)	14.91
Exercised (in dollars per share)	8.38
Forfeited (in dollars per share)	14.98
Ending balance (in dollars per share)	19.95
Exercisable, ending balance (in dollars per share)	$ 19.95

Stock-Based Compensation - Sc_3

Stock-Based Compensation - Schedule of Fair Value of Each Stock Option and PSU Award Granted (Details)	6 Months Ended
	Jun. 30, 2024 $ / shares
Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate (%) - (Minimum)	3.80%
Risk-free interest rate (%) - (Maximum)	4.60%
Expected volatility (%) - (Minimum)	54.90%
Expected volatility (%) - (Maximum)	64.60%
Dividend yield (%)	0%
Weighted average fair value at grant date (in dollars per share)	$ 8.85
PSU
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	3 years
Risk-free interest rate (%) - (Minimum)	4.50%
Risk-free interest rate (%) - (Maximum)	4.70%
Expected volatility (%) - (Minimum)	71.30%
Expected volatility (%) - (Maximum)	72.20%
Dividend yield (%)	0%
Weighted average fair value at grant date (in dollars per share)	$ 17.43
Minimum | Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 6 months
Maximum | Stock options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	6 years 6 months

Stock-Based Compensation - Sc_4

Stock-Based Compensation - Schedule of Restricted Stock Activity (Details)	6 Months Ended
	Jun. 30, 2024 $ / shares shares
Restricted stock awards
Number of Restricted Shares
Beginning balance (in shares) | shares	1,961,919
Granted (in shares) | shares	967,256
Vested (in shares) | shares	(397,856)
Forfeited (in shares) | shares	(148,685)
Ending balance (in shares) | shares	2,382,634
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share) | $ / shares	$ 13.83
Granted (in dollars per share) | $ / shares	14.94
Vested (in dollars per share) | $ / shares	14.70
Forfeited (in dollars per share) | $ / shares	14.25
Ending balance (in dollars per share) | $ / shares	$ 14.11
PSU
Number of Restricted Shares
Beginning balance (in shares) | shares	305,105
Granted (in shares) | shares	388,513
Vested (in shares) | shares	0
Forfeited (in shares) | shares	(46,534)
Ending balance (in shares) | shares	647,084
Weighted Average Grant Date Fair Value
Beginning balance (in dollars per share) | $ / shares	$ 21.83
Granted (in dollars per share) | $ / shares	17.43
Vested (in dollars per share) | $ / shares	0
Forfeited (in dollars per share) | $ / shares	19.56
Ending balance (in dollars per share) | $ / shares	$ 19.35

Revenue Recognition - Narrative

Revenue Recognition - Narrative (Details) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) segment	Jun. 30, 2023 USD ($)
Revenue from Contract with Customer [Abstract]
Number of operating segments | segment			2
Pharma contract liability, revenue recognized	$ 0.3	$ 1.7	$ 1.4	$ 3.5
Amortization of contract commissions	$ 0.2	$ 0.3	$ 0.5	$ 0.5

Revenue Recognition - Schedule

Revenue Recognition - Schedule of Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Contract with Customer, Asset, Net [Abstract]
Current contract assets	$ 0	$ 37
Long-term contract assets	0	0
Total contract assets	0	37
Capitalized Contract Cost [Abstract]
Current capitalized commissions	711	935
Long-term capitalized commissions	171	53
Total capitalized commissions	882	988
Contract with Customer, Liability [Abstract]
Current contract liabilities	972	2,130
Long-term contract liabilities	349	0
Total contract liabilities	$ 1,321	$ 2,130

Revenue Recognition - Schedul_2

Revenue Recognition - Schedule of Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Disaggregation of Revenue [Line Items]
Total Revenue	$ 164,502	$ 146,917	$ 320,742	$ 284,137
Clinical Services
Disaggregation of Revenue [Line Items]
Total Revenue	141,388	123,156	275,923	238,025
Clinical Services | Client direct billing
Disaggregation of Revenue [Line Items]
Total Revenue	95,191	83,176	185,674	159,999
Clinical Services | Commercial insurance
Disaggregation of Revenue [Line Items]
Total Revenue	24,843	21,695	48,447	43,050
Clinical Services | Medicare and Medicaid
Disaggregation of Revenue [Line Items]
Total Revenue	21,197	18,196	41,566	34,783
Clinical Services | Self-Pay
Disaggregation of Revenue [Line Items]
Total Revenue	157	89	236	193
Advanced Diagnostics
Disaggregation of Revenue [Line Items]
Total Revenue	$ 23,114	$ 23,761	$ 44,819	$ 46,112

Restructuring - Narrative (Deta

Restructuring - Narrative (Details) $ in Millions	Jun. 30, 2024 USD ($)
Restructuring Cost and Reserve [Line Items]
Restructuring cost	$ 1.7
Severance and Other Employee Costs
Restructuring Cost and Reserve [Line Items]
Restructuring cost	0.3
Facility Footprint Optimization
Restructuring Cost and Reserve [Line Items]
Restructuring cost	1.2
Consulting costs
Restructuring Cost and Reserve [Line Items]
Restructuring cost	$ 0.2

Restructuring - Schedule of Res

Restructuring - Schedule of Restructuring Activities (Details) - Improve Execution and Efficiency Across Organization - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2024	Mar. 31, 2024
Restructuring Reserve [Roll Forward]
Beginning balance	$ 1,319	$ 2,613
Restructuring charges incurred	1,464	2,408
Impairment of facility related assets	80	(10)
Cash payments and other adjustments	(1,648)	(3,692)
Ending balance	1,215	1,319
Current liabilities	1,215
Long-term liabilities	0
Restructuring reserve	1,215	1,319
Severance and Other Employee Costs
Restructuring Reserve [Roll Forward]
Beginning balance	613	687
Restructuring charges incurred	703	697
Impairment of facility related assets	0	0
Cash payments and other adjustments	(575)	(771)
Ending balance	741	613
Restructuring reserve	741	613
Facility Footprint Optimization
Restructuring Reserve [Roll Forward]
Beginning balance	547	1,389
Restructuring charges incurred	650	964
Impairment of facility related assets	80	(10)
Cash payments and other adjustments	(957)	(1,796)
Ending balance	320	547
Restructuring reserve	320	547
Consulting and Other Costs
Restructuring Reserve [Roll Forward]
Beginning balance	159	537
Restructuring charges incurred	111	747
Impairment of facility related assets	0	0
Cash payments and other adjustments	(116)	(1,125)
Ending balance	154	159
Restructuring reserve	$ 154	$ 159

Net Loss Per Share - Schedule o

Net Loss Per Share - Schedule of Basic and Diluted Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Earnings Per Share [Abstract]
NET LOSS	$ (18,642)	$ (24,331)	$ (45,703)	$ (55,126)
Basic weighted average shares outstanding (in shares)	126,405	125,356	126,257	125,192
Diluted weighted average shares outstanding (in shares)	126,405	125,356	126,257	125,192
Basic net loss per share (in dollars per share)	$ (0.15)	$ (0.19)	$ (0.36)	$ (0.44)
Diluted net loss per share (in dollars per share)	$ (0.15)	$ (0.19)	$ (0.36)	$ (0.44)

Net Loss Per Share - Schedule_2

Net Loss Per Share - Schedule of Antidilutive Shares (Details) - USD ($) $ / shares in Units, $ in Millions		3 Months Ended		6 Months Ended
	Jan. 11, 2021	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Jun. 28, 2024
Capped Call Transactions
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Proceeds from convertible debt	$ 29.3
Offering price per share (in dollars per share)						$ 85.75
2028 Convertible Notes | Convertible Debt
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Convertible notes, conversion price (in dollars per share)		$ 13.87		$ 13.87		$ 13.87
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		406,000	574,000	477,000	474,000
Restricted stock awards
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		1,012,000	1,016,000	1,026,000	987,000
Convertible Debt Securities | 2025 Convertible 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 | 2028 Convertible 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	5,215,000
PSU
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)		647,084		647,084

Commitments and Contingencies (

Commitments and Contingencies (Details) $ in Millions						6 Months Ended
	Jan. 12, 2024 USD ($)	Dec. 27, 2023 patent	Jul. 28, 2023 patent	Dec. 20, 2022 patent	Jan. 20, 2021 patent	Jun. 30, 2024 USD ($) patent petition	Dec. 31, 2023 USD ($)
Contractual Obligation [Line Items]
Loss contingency, number of review petitions | petition						2
Patent Infringement Complaint
Contractual Obligation [Line Items]
Number of patents allegedly infringed upon | patent			2	1	2	2
Loss contingency, bond posted by plaintiff | $	$ 10
Loss contingency, court initial determination, patents infringed, number | patent		1
Federal Healthcare Program Revenue
Contractual Obligation [Line Items]
Loss contingency accrual | $						$ 11.2	$ 11.2

Related Party Transactions (Det

Related Party Transactions (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Related Party Transaction [Line Items]
Total Revenue	$ 164,502	$ 146,917	$ 320,742	$ 284,137
Related Party | HOOKIPA Pharma, Inc.
Related Party Transaction [Line Items]
Total Revenue		$ 0		$ 200

Segment Information - Narrative

Segment Information - Narrative (Details)	6 Months Ended
	Jun. 30, 2024 segment
Segment Reporting [Abstract]
Number of reportable segments	2

Segment Information - Schedule

Segment Information - Schedule of Segment Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Segment Reporting Information [Line Items]
Total Revenue	$ 164,502	$ 146,917	$ 320,742	$ 284,137
Total cost of revenue	92,008	87,026	182,779	169,432
GROSS PROFIT	72,494	59,891	137,963	114,705
Stock-based compensation			16,615	10,463
Clinical Services
Segment Reporting Information [Line Items]
Total Revenue	141,388	123,156	275,923	238,025
Total cost of revenue	78,094	71,746	154,938	139,038
GROSS PROFIT	63,294	51,410	120,985	98,987
Amortization of acquired intangible assets	4,300	4,300	8,600	8,500
Stock-based compensation	200	0	500	0
Advanced Diagnostics
Segment Reporting Information [Line Items]
Total Revenue	23,114	23,761	44,819	46,112
Total cost of revenue	13,914	15,280	27,841	30,394
GROSS PROFIT	9,200	8,481	16,978	15,718
Amortization of acquired intangible assets	600	600	1,200	1,200
Stock-based compensation	$ 100	$ 0	$ 200	$ 0