Fulgent Genetics (FLGT) 10-Q 3 May 24 2024 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2024	May 01, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Trading Symbol	FLGT
Entity Registrant Name	FULGENT GENETICS, INC.
Entity Central Index Key	0001674930
Entity Current Reporting Status	Yes
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		29,924,288
Entity File Number	001-37894
Entity Tax Identification Number	81-2621304
Entity Address, Address Line One	4399 Santa Anita Avenue
Entity Address, City or Town	El Monte
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	91731
City Area Code	626
Local Phone Number	350-0537
Title of 12(b) Security	Common Stock, par value $0.0001 per share
Security Exchange Name	NASDAQ
Entity Interactive Data Current	Yes
Document Quarterly Report	true
Document Transition Report	false
Entity Incorporation, State or Country Code	DE

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 54,677	$ 97,473
Marketable securities	251,018	326,681
Trade accounts receivable, net of allowance for credit losses of $25,831 and $25,226	52,060	51,132
Other current assets	28,754	32,559
Total current assets	386,509	507,845
Marketable securities, long-term	540,495	423,571
Redeemable preferred stock investment	20,438	20,438
Fixed assets, net	86,723	83,464
Intangible assets, net	140,989	143,053
Goodwill, net	22,055	22,055
Other long-term assets	32,676	34,902
Total assets	1,229,885	1,235,328
Current liabilities
Accounts payable	19,616	15,360
Accrued liabilities	25,918	30,737
Customer deposit	27,240	22,700
Contract liabilities	2,762	2,874
Notes payable, current portion	413	1,183
Other current liabilities	0	164
Total current liabilities	75,949	73,018
Deferred tax liabilities	7,405	7,962
Unrecognized tax benefits	5,978	5,978
Other long-term liabilities	13,907	15,084
Total liabilities	103,239	102,042
Commitments and contingencies (Note 8)
Stockholders’ equity
Common stock, $0.0001 par value per share, 50,000 shares authorized, 32,664 and 32,416 shares issued, respectively, and 29,890 and 29,653 shares outstanding, respectively	3	3
Preferred stock, $0.0001 par value per share, 1,000 shares authorized, no shares issued or outstanding
Additional paid-in capital	511,329	501,718
Accumulated other comprehensive (loss) income	(1,102)	1,205
Retained earnings	619,713	633,175
Total Fulgent stockholders' equity	1,129,943	1,136,101
Noncontrolling interest	(3,297)	(2,815)
Total stockholders’ equity	1,126,646	1,133,286
Total liabilities and stockholders’ equity	$ 1,229,885	$ 1,235,328

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Allowance for credit losses at beginning of year	$ 25,831	$ 25,226
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	50,000,000	50,000,000
Common stock, shares issued	32,664,000	32,416,000
Common stock, shares outstanding	29,890,000	29,653,000
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	1,000,000	1,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (unaudited) - USD ($) shares in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Revenue	$ 64,485,000	$ 66,168,000
Cost of revenue	42,381,000	47,357,000
Gross profit	22,104,000	18,811,000
Operating expenses:
Research and development	11,434,000	9,782,000
Selling and marketing	8,989,000	10,083,000
General and administrative	21,489,000	21,802,000
Amortization of intangible assets	1,990,000	1,968,000
Total operating expenses	43,902,000	43,635,000
Operating loss	(21,798,000)	(24,824,000)
Interest and other income, net	7,625,000	3,775,000
Loss before income taxes	(14,173,000)	(21,049,000)
Benefit from income taxes	(327,000)	(5,200,000)
Net loss from consolidated operations	(13,846,000)	(15,849,000)
Net loss attributable to noncontrolling interests	384,000	509,000
Net loss attributable to Fulgent	$ (13,462,000)	$ (15,340,000)
Net loss per common share attributable to Fulgent:
Basic	$ (0.45)	$ (0.52)
Diluted	$ (0.45)	$ (0.52)
Weighted-average common shares:
Basic	29,769	29,536
Diluted	29,769	29,536

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Comprehensive Income (Loss) (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Comprehensive Income [Abstract]
Net loss from consolidated operations	$ (13,846)	$ (15,849)
Other comprehensive income (loss):
Foreign currency translation (loss) gain	(333)	168
Net (loss) gain on available-for-sale debt securities, net of tax	(2,072)	5,329
Comprehensive loss from consolidated operations	(16,251)	(10,352)
Net loss attributable to noncontrolling interest	384	509
Foreign currency translation loss (gain) attributable to noncontrolling interest	98	(1,790)
Comprehensive loss (income) attributable to noncontrolling interest	482	(1,281)
Comprehensive loss attributable to Fulgent	$ (15,769)	$ (11,633)

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Stockholders' Equity (unaudited) - USD ($)	Total	Stockholders' Equity	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Retained Earnings	Fulgent Stockholders' Equity	Noncontrolling Interest
Beginning Balance at Dec. 31, 2022	$ 1,269,875,000	$ 3,000	$ 486,585,000	$ (20,903,000)	$ 801,000,000	$ 1,266,685,000	$ 3,190,000
Beginning Balance, Shares at Dec. 31, 2022		29,438,000
Equity-based compensation	10,265,000		10,265,000			10,265,000
Restricted stock awards, Shares		280,000
Common stock withholding for employee tax obligations	$ (869,000)		(869,000)			(869,000)
Common stock withholding for employee tax obligations, Shares		(26,000)
Repurchase of common stock, Shares	0
Other comprehensive income (loss)	$ 5,497,000			3,707,000		3,707,000	1,790,000
Net income (loss)	(15,849,000)				(15,340,000)	(15,340,000)	(509,000)
Ending Balance at Mar. 31, 2023	1,268,919,000	$ 3,000	495,981,000	(17,196,000)	785,660,000	1,264,448,000	4,471,000
Ending Balance, Shares at Mar. 31, 2023		29,692,000
Beginning Balance at Dec. 31, 2023	$ 1,133,286,000	$ 3,000	501,718,000	1,205,000	633,175,000	1,136,101,000	(2,815,000)
Beginning Balance, Shares at Dec. 31, 2023	32,416,000	29,653,000
Equity-based compensation	$ 11,518,000		11,518,000			11,518,000
Exercise of common stock options, Shares		1,000
Restricted stock awards, Shares		315,000
Common stock withholding for employee tax obligations	(1,682,000)		(1,682,000)			(1,682,000)
Common stock withholding for employee tax obligations, Shares		(69,000)
Repurchase of common stock	$ (225,000)		(225,000)			(225,000)
Repurchase of common stock, Shares	(10,000)	(10,000)
Other comprehensive income (loss)	$ (2,405,000)			(2,307,000)		(2,307,000)	(98,000)
Net income (loss)	(13,846,000)				(13,462,000)	(13,462,000)	(384,000)
Ending Balance at Mar. 31, 2024	$ 1,126,646,000	$ 3,000	$ 511,329,000	$ (1,102,000)	$ 619,713,000	$ 1,129,943,000	$ (3,297,000)
Ending Balance, Shares at Mar. 31, 2024	32,664,000	29,890,000

Condensed Consolidated Statem_4

Condensed Consolidated Statements of Stockholders' Equity (unaudited) (Parenthetical) - shares	Mar. 31, 2024	Mar. 31, 2023
Common stock shares not issued and holdback as partial security for indemnification obligations	185,503	371,006

Condensed Consolidated Statem_5

Condensed Consolidated Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash flow from operating activities:
Net loss from consolidated operations	$ (13,846)	$ (15,849)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Equity-based compensation	11,518	10,265
Depreciation and amortization	6,663	6,879
Gain for credit losses	(2,497)	(113)
Noncash lease expense	1,510	1,561
Loss (gain) on disposal of fixed asset	183	(179)
Amortization of discount of marketable securities	(1,184)	(478)
Deferred taxes	(557)	(5,200)
Net realized loss on marketable securities	580
Other	(12)
Changes in operating assets and liabilities:
Trade accounts receivable	1,484	9,331
Other current and long-term assets	5,130	(1,629)
Accounts payable	(245)	(1,855)
Accrued liabilities and other liabilities	51	(9,114)
Operating and finance lease liabilities	(1,512)	(1,526)
Net cash provided by (used in) operating activities	7,266	(7,907)
Cash flow from investing activities:
Purchase of marketable securities	(195,741)	(143,926)
Purchases of fixed assets	(4,056)	(2,034)
Proceeds from sale of fixed assets	258	198
Maturities of marketable securities	95,450	141,408
Proceeds from sale of marketable securities	56,903
Net cash used in investing activities	(47,186)	(4,354)
Cash flow from financing activities:
Common stock withholding for employee tax obligations	(1,682)	(869)
Repayment of notes payable	(765)
Repurchase of common stock	(225)
Principal paid for finance lease	(135)	(232)
Net cash used in financing activities	(2,807)	(1,101)
Effect of exchange rate changes on cash and cash equivalents	(69)	28
Net decrease in cash and cash equivalents	(42,796)	(13,334)
Cash and cash equivalents at beginning of period	97,473	79,506
Cash and cash equivalents at end of period	54,677	66,172
Supplemental disclosures of cash flow information:
Income taxes paid	1,307	1,680
Cash paid for interest	439
Supplemental disclosures of non-cash investing and financing activities:
Purchases of marketable securities in other current liabilities		3,519
Purchases of fixed assets in accounts payable	4,739	$ 2,537
Sale of fixed assets in other receivable	11
Operating lease right-of-use assets reduced due to lease termination	$ 57

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (13,462)	$ (15,340)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Mar. 31, 2024
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	During the three months ended March 31, 2024, no ne of our directors or officers adopted or terminated “Rule 10b5-1 trading arrangement” or “non-Rule 10b5-1 trading arrangement,” as each term is defined in Item 408 of Regulation S-K.
Director And Officer [Member]
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

Overview and Basis of Presentat

Overview and Basis of Presentation	3 Months Ended
	Mar. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Overview and Basis of Presentation	Note 1. Overview and Basis of Presentation The accompanying condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America, or U.S. GAAP. These financial statements include the assets, liabilities, revenues and expenses of all subsidiaries and entities in which the Company has a controlling financial interest or is deemed to be the primary beneficiary. In determining whether the Company is the primary beneficiary of an entity, the Company applies a qualitative approach that determines whether it has both (i) the power to direct the economically significant activities of the entity and (ii) the obligation to absorb losses of, or the right to receive benefits from, the entity that could potentially be significant to that entity. The Company uses the equity method to account for its investments in entities that it does not control, but in which it has the ability to exercise significant influence over operating and financial policies. All intercompany accounts and transactions are eliminated from the accompanying condensed consolidated financial statements. Nature of the Business Fulgent Genetics, Inc., together with its subsidiaries and affiliated professional corporations, or PCs (collectively referred to as the Company, unless otherwise noted or the context otherwise requires), is a technology-based company with a well-established laboratory services business and a therapeutic development business. Its laboratory services business – to which the Company formerly referred as its clinical diagnostic business, includes technical laboratory services and professional interpretation of laboratory results by licensed physicians. Its therapeutic development business is focused on developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform designed to improve the therapeutic window and pharmacokinetic profile of new and existing cancer drugs. Unaudited Interim Financial Information The accompanying unaudited interim condensed consolidated financial statements have been prepared on the same basis as the Company’s audited consolidated financial statements as of and for the fiscal year ended December 31, 2023, which are included in the Company’s annual report on Form 10-K filed with the Securities and Exchange Commission, or SEC, on February 28, 2024, or the 2023 Annual Report, and, in the opinion of management, include all adjustments, which are normal and recurring in nature, necessary for a fair presentation of the Company’s financial position and results of operations. Operating results for interim periods are not necessarily indicative of the results that may be expected for a full fiscal year or any other period. The accompanying Condensed Consolidated Balance Sheet as of December 31, 2023 has been derived from the Company’s audited consolidated financial statements at that date but does not include all of the disclosures required by U.S. GAAP. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements included in the 2023 Annual Report, including the notes thereto.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies See the summary of the Company’s significant accounting policies set forth in the notes to its consolidated financial statements included in the 2023 Annual Report. Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make certain estimates, judgments and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements, as well as the reported amounts of revenue and expenses during the reporting periods. These estimates, judgments and assumptions are based on historical data and experience available at the date of the accompanying condensed consolidated financial statements, as well as various other factors management believes to be reasonable under the circumstances. The Company’s estimates and assumptions may evolve as conditions change. Actual results could differ significantly from these estimates. On an on-going basis, management evaluates its estimates, primarily those related to: (i) revenue recognition criteria, (ii) accounts receivable and allowances for credit losses, (iii) the useful lives of fixed assets and intangible assets, (iv) estimates of tax liabilities, (v) valuation of intangible assets and goodwill at time of acquisition and on a recurring basis, and (vi) valuation of investments. Trade Accounts Receivable and Allowance for Credit Losses Trade accounts receivable are stated at the amount the Company expects to collect. The Company maintains an allowance for credit losses for expected uncollectible trade accounts receivable, which is recorded as an offset to trade accounts receivable, and changes in allowance for credit losses are classified as a general and administrative expense in the accompanying Condensed Consolidated Statements of Operations. The Company assesses collectability by reviewing trade accounts receivable on a collective basis where similar risk characteristics exist and on an individual basis when it identifies specific customers that have deterioration in credit quality such that they may no longer share similar risk characteristics with the other receivables. In determining the amount of the allowance for credit losses, the Company uses a loss rate model or probability-of-default and loss given default model. Following the loss rate method, expected credit losses are determined based on an estimated historical loss rate. The probability of default method allows the ability to define a point of default and measure credit losses for receivables that have reached the point of default for purposes of calculating the allowance for credit losses. Loss given default represents the likelihood that a receivable that has reached the point of default will not be collected in full. The Company updates its loss rate and factors annually to incorporate the most recent historical data and adjusts the quantitative portion of the reserve through its qualitative reserve overlay. The Company looks at qualitative factors such as general economic conditions in determining expected credit losses. The roll-forward for the allowance for credit losses for the three months ended March 31, 2024, dollars in thousands, is as follows: Allowance for credit losses at beginning of year $ 25,226 Current period provision ( 2,497 ) Write-downs ( 1,336 ) Recoveries of amounts previously charged off 4,438 Allowance for credit losses as of March 31, 2024 $ 25,831 Redeemable Preferred Stock Investment The redeemable preferred stock investment of $ 20.4 million as of March 31, 2024 represents the fair value of redeemable preferred stock of a private company that the Company purchased in July 2021. The investment is classified as available-for-sale debt securit ies. The fair value of available-for-sale debt security is included in the Condensed Consolidated Statement of Balance Sheets. Unrealized gain of $ 597,000 was ex cluded from earnings and reported in other comprehensive loss in the three months ended March 31, 2023, and there was no unrealized gain or loss in the three months ended March 31, 2024. Since the Company intends on holding the preferred stock, and the preferred stock is not redeemable until July 2027 , the investment is recorded as a long-term investment. Finite-Lived Intangible assets Intangible assets, unless determined to be indefinite-lived, are amortized over their estimated useful lives. The Company amortizes intangible assets on a straight-line basis with definite lives generally over periods ranging from three to fourteen years . See Note 14, Goodwill and Acquisition-Related Intangibles , for details of intangible assets. Impairment of Long-Lived Assets The Company evaluates the carrying amount of its long-lived assets whenever events or changes in circumstances indicate that the assets may not be recoverable. An impairment loss would be recognized when estimated future cash flows expected to result from the use of an asset and its eventual disposition is less than the carrying amount of the asset. Goodwill and Indefinite-Lived Intangibles Intangibles in-process research & development costs, or IPR&D, are considered to be indefinite-lived until the completion or abandonment of the associated research and development efforts. If and when development is complete, the associated assets would be deemed finite-lived and would then be amortized based on their respective estimated useful lives at that point in time. The Company assesses goodwill and indefinite-lived intangibles for impairment on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. The Company may choose to bypass a qualitative assessment of impairment for any reporting unit and proceed directly to performing a quantitative assessment. An impairment loss would be recognized for the amount by which the reporting unit's carrying amount exceeds its fair value. The Company’s quantitative assessment includes estimating the fair value of each reporting unit and comparing it to its carrying value. The Company estimates the fair value of reporting units using both income-based and market-based valuation methods and typically engages a third-party appraisal firm to assist with the valuation. The estimated fair value for each reporting unit is determined based upon the range of estimated values developed from the income and market-based methods. If the estimated fair value of a reporting unit exceeds its carrying value, the goodwill is not impaired, and no further review is required. The income-based fair value methodology is based on a reporting unit’s forecasted future cash flows that are discounted to the present value using the reporting unit’s weighted average cost of capital. Under the income-based approach, it requires management's assumptions and judgments regarding economic conditions in the markets in which the company operates and conditions in the capital markets, many of which are outside of management's control. The market-based fair value methodology looks at the guideline public company valuation method to determine the prices of comparable public companies and looks at merger and acquisition methods, similar businesses that were sold recently, to estimate the value of the reporting units. Under the market-based approach, judgment is required in evaluating market multiples and recent transactions. Fair Value of Financial Instruments The Company’s financial instruments consist principally of cash and cash equivalents, marketable securities, trade accounts receivable, redeemable preferred stock investment, accounts payable, and accrued liabilities. The carrying amounts of certain of these financial instruments, including cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities approximate fair value due to their short maturities. Fair value of marketable securities and redeemable preferred stock investment is disclosed in Note 4, Fair Value Measurements , to the accompanying consolidated financial statements. Concentrations of Credit Risk, Customers, and Suppliers Financial instruments that potentially subject the Company to significant concentrations of credit risk consist primarily of cash and cash equivalents, trade accounts receivable, and marketable securities, which consist of debt securities and equity securities. As of March 31, 2024, substantially all of the Company’s cash and cash equivalents were deposited in accounts at financial institutions, and amounts may exceed federally insured limits. Management believes that the Company is not exposed to significant credit risk due to the financial strength of the depository institutions in which its cash and cash equivalents are held. In certain periods, a small number of customers has accounted for a significant portion of the Company’s revenue. For the laboratory services business, aggregating customers under common control, one customer comprised of $ 12.6 million or 20 % of total revenue in the three months ended as of March 31, 2024. No customer contributed 10 % or more of the Company's revenue in the three months ended March 31, 2023. One customer comprised 12 % of total accounts receivable, net, as of March 31, 2024, and comprised 13 % of total accounts receivable, net, as of December 31, 2023. For the therapeutic development business, as of March 31, 2024 and December 31, 2023, there is no concentration risk, as there are no customers or revenue, as it does not have any commercialized or approved product candidates. The Company relies on a limited number of suppliers for certain laboratory substances used in the chemical reactions incorporated into its processes, referred to as reagents, as well as for the sequencers and various other equipment and materials it uses in its laboratory operations. In particular, the Company relies on a sole supplier for the next generation sequencers and associated reagents it uses to perform its genetic tests and as the sole provider of maintenance and repair services for these sequencers. The operations of the laboratory services business would be interrupted if it encountered delays or difficulties securing these reagents, sequencers, other equipment or materials or maintenance and repair services, which could occur for a variety of reasons, including if the Company needs a replacement or temporary substitute for any of its limited or sole suppliers and is not able to locate and make arrangements with an acceptable replacement or temporary substitute. The Company's development efforts could also be delayed or interrupted if is unable to procure items needed for its therapeutic development activities. The Company’s therapeutic development business also relies on ANP Technologies, Inc., or ANP, for certain laboratory services, equipment, tools, and drug intermediates in connection with research and development efforts. The Company believes there are currently only a few other manufacturers that are capable of supplying and servicing some of the equipment and other materials necessary for its laboratory operations, including collection kits, sequencers and various associated reagents. Reportable Segment and Geographic Information Reportable segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision-maker, or CODM, in making decisions regarding resource allocation and assessing performance. The Company’s CODM is its Chief Executive Officer. The Company reports its business in two segments, a laboratory services business and a therapeutic development business. For further financial information about these segments, including information for each of the periods presented regarding revenue, operating income (loss), and other important information, see Note 7, Reportable Segment and Geographic Information . Foreign Currency Translation and Foreign Currency Transactions The Company translates the assets and liabilities of its non-U.S. dollar functional currency subsidiaries into U.S. dollars using exchange rates in effect at the end of each period. Expenses for these subsidiaries are translated using rates that approximate those in effect during the period. Gains and losses from these translations are recognized in foreign currency translation included in accumulated other comprehensive (loss) income in the accompanying Condensed Consolidated Statements of Stockholders’ Equity. The Company and its subsidiaries that use the U.S. dollar as their functional currency remeasure monetary assets and liabilities at exchange rates in effect at the end of each period, and inventories, property and nonmonetary assets and liabilities are measured at historical rates. Losses from these remeasurements were not significant in the three months ended March 31, 2024 and 2023. Comprehensive Income (Loss) Comprehensive income (loss) is comprised of net income (loss) and other comprehensive income (loss). Other comprehensive income (loss) consists of net unrealized gain or loss on available-for-sale debt securities, net of tax, and foreign currency translation adjustments from the Company's subsidiaries not using the U.S. dollar as their functional currency. There were no reclassifications from other comprehensive income (loss) to net loss in the three months ended March 31, 2024 or 2023. The tax effect related to net unrealized losses on available-for-sale debt securities was zero for the three months ended March 31, 2024 due to the valuation allowance in the current period that precludes the Company from recognizing the deferred tax benefit. The tax effect related to net unrealized losses was $ 1.9 million for the three months ended March 31, 2023. Disaggregation of Revenue The Company classifies its customers into three payor types: (i) Insurance, (ii) Institutions, including hospitals, medical institutions, other laboratories, governmental bodies, municipalities and large corporations, or (iii) Patients who pay directly. The Company believes these classifications best depict how the nature, amount, timing, and uncertainty of its revenue and cash flows are affected by economic factors. The following table summarizes revenue from contracts with customers by payor type for the three months ended March 31, 2024 and 2023. Three Months Ended March 31, 2024 2023 (in thousands) Testing Services by Payor Institutional $ 33,604 $ 30,992 Insurance 30,043 34,551 Patient 838 625 Total Revenue $ 64,485 $ 66,168 $ 1.2 million variable consideration was recognized in the three months ended March 31, 2024, that related to COVID-19 tests completed in the prior periods due to the recent collection efforts, which was included as revenue from insurance in the table above. During the three months ended March 31, 2024, the Company experienced a change in estimate related to variable consideration. The Company estimates variable consideration using the expected value method. Any changes in variable consideration estimates that affect transactions are accounted for on a cumulative catch-up basis. There was no material variable consideration recognized in the three months ended March 31, 2023. Contract Balances Receivables from contracts with customers - Receivables from contracts with customers are included within trade accounts receivable on the Condensed Consolidated Balance Sheets. Receivables from Insurance and Institutional customers represented 43 % and 57 % , respectively, as of March 31, 2024 and 39 % and 61 %, respectively, as of December 31, 2023. Contracts assets and liabilities - Contract assets from contracts with customers associated with contract execution and certain costs to fulfill a contract are included in other current assets in the accompanying Condensed Consolidated Balance Sheets. Contract liabilities are recorded when the Company receives payment prior to completing its obligation to transfer goods or services to a customer. Contract liabilities are included in the Condensed Consolidated Balance Sheets. Revenues of $ 860,000 and $ 1.3 million were recognized for the three months ended March 31, 2024 and 2023, respectively, related to contract liabilities at the beginning of the respective periods. Recent Accounting Pronouncements The Company evaluates all Accounting Standards Updates, or ASUs, issued by the Financial Accounting Standards Board, or FASB, for consideration of their applicability. ASUs not included in the Company’s disclosures were assessed and determined to be either not applicable or are not expected to have a material impact on the Company’s condensed consolidated financial statements. In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280), Improvements to Reportable Segments. This update improves reportable segment disclosure requirements and requires enhanced disclosures related to significant segment expenses regularly provided to CODM, the amount for other segment items with descriptions of the composition, segment profit or loss, and clarification on if the CODM uses more than one measurement of a segment's profit or loss in assessing segment performance and deciding how to allocate resources. Amendments in this update are effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. The Company is currently evaluating the impacts of this amendment on the consolidated financial statements and related disclosure. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvement to Income Tax Disclosures. The update requires more detailed information on certain income tax disclosures including the income tax rate reconciliation and income taxes paid. Amendments in this update are effective for annual periods beginning December 15, 2024 for public entities, and early adoption is permitted. The Company is currently evaluating the impacts of this amendment on the consolidated financial statements and related disclosure. The Company does not expect that any other recently issued accounting guidance will have a significant effect on its consolidated financial statements.

Equity and Debt Securities

Equity and Debt Securities	3 Months Ended
	Mar. 31, 2024
Investments, Debt and Equity Securities [Abstract]
Equity and Debt Securities	Note 3. Equity and Debt Securities The Company’s equity and debt securities consisted of the following: March 31, 2024 Amortized Unrealized Unrealized Aggregate (in thousands) Equity securities: Long-term Preferred stock of privately held company $ 15,000 $ — $ — $ 15,000 Total equity securities 15,000 — — 15,000 Available-for-sale debt securities Short-term U.S. government debt securities 106,187 — ( 1,059 ) 105,128 U.S. agency debt securities 57,328 — ( 1,071 ) 56,257 U.S. treasury bills 45,613 — ( 4 ) 45,609 Corporate debt securities 39,655 — ( 299 ) 39,356 Money market accounts 21,718 — — 21,718 Municipal bonds 4,696 — ( 28 ) 4,668 Less: Cash equivalents ( 21,718 ) — — ( 21,718 ) Total debt securities due within 1 year 253,479 — ( 2,461 ) 251,018 After 1 year through 5 years U.S. government debt securities 345,156 284 ( 2,102 ) 343,338 U.S. agency debt securities 151,721 5 ( 1,412 ) 150,314 Corporate debt securities 41,025 — ( 760 ) 40,265 Redeemable preferred stock investment 20,000 438 — 20,438 Municipal bonds 5,061 1 ( 35 ) 5,027 Yankee debt securities 752 — ( 59 ) 693 Total debt securities due after 1 year through 5 years 563,715 728 ( 4,368 ) 560,075 After 5 years through 10 years Municipal bonds 864 1 ( 7 ) 858 Total debt securities due after 5 years through 10 years 864 1 ( 7 ) 858 Total available-for-sale debt securities 818,058 729 ( 6,836 ) 811,951 Total equity and debt securities $ 833,058 $ 729 $ ( 6,836 ) $ 826,951 December 31, 2023 Amortized Unrealized Unrealized Aggregate (in thousands) Equity securities: Long-term Preferred stock of privately held company $ 15,000 $ — $ — $ 15,000 Total equity securities 15,000 — — 15,000 Available-for-sale debt securities Short-term U.S. government debt securities 119,739 8 ( 1,765 ) 117,982 U.S. agency debt securities 72,310 — ( 1,414 ) 70,896 U.S. treasury bills 69,214 36 — 69,250 Corporate debt securities 63,810 — ( 792 ) 63,018 Money market accounts 38,291 — — 38,291 Municipal bonds 5,557 1 ( 23 ) 5,535 Less: Cash equivalents ( 38,291 ) — — ( 38,291 ) Total debt securities due within 1 year 330,630 45 ( 3,994 ) 326,681 After 1 year through 5 years U.S. government debt securities 247,104 1,262 ( 578 ) 247,788 U.S. agency debt securities 156,150 161 ( 490 ) 155,821 Corporate debt securities 12,885 — ( 765 ) 12,120 Municipal bonds 6,337 2 ( 48 ) 6,291 Yankee debt securities 752 — ( 60 ) 692 Redeemable preferred stock investment 20,000 438 — 20,438 Total debt securities due after 1 year through 5 years 443,228 1,863 ( 1,941 ) 443,150 After 5 years through 10 years Municipal bonds 868 1 ( 10 ) 859 Total debt securities due after 5 years through 10 years 868 1 ( 10 ) 859 Total available-for-sale debt securities 774,726 1,909 ( 5,945 ) 770,690 Total equity and debt securities $ 789,726 $ 1,909 $ ( 5,945 ) $ 785,690 Gross unrealized losses on the Company’s equity and debt securities were $ 6.8 million and $ 5.9 million as of March 31, 2024 and December 31, 2023, respectively. The Company did not recognize any credit losses for its available-for-sale debt securities during the three months ended March 31, 2024 and 2023.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	Note 4. Fair Value Measurements The authoritative guidance on fair value measurements establishes a framework with respect to measuring assets and liabilities at fair value on a recurring basis and non-recurring basis. Under the framework, fair value is defined as the exit price, or the amount that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants, as of the measurement date. The framework also establishes a three-tier hierarchy for inputs used in measuring fair value that maximizes the use of observable inputs and minimizes the use of unobservable inputs by requiring that the most observable inputs be used when available. Observable inputs are inputs market participants would use in valuing the asset or liability and are developed based on market data obtained from sources independent of the Company. Unobservable inputs are inputs that reflect the Company’s assumptions about the factors market participants would use in valuing the asset or liability and are developed based on the best information available in the circumstances. The hierarchy consists of the following three levels: Level 1: Inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities that the reporting entity can access at the measurement date. Level 2: Inputs are inputs other than quoted prices included within Level 1 that are observable for the asset or liability, either directly or indirectly. Level 3: Inputs are unobservable for the asset or liability. The following tables present information about the Company’s financial assets measured at fair value on a recurring basis, based on the above three-tier fair value hierarchy: March 31, 2024 Total Level 1 Level 2 Level 3 (in thousands) Equity securities, debt securities and cash equivalents: U.S. government debt securities $ 448,466 $ — $ 448,466 $ — U.S. agency debt securities 206,571 — 206,571 — Corporate debt securities 79,621 — 79,621 — U.S. treasury bills 45,609 45,609 — — Money market accounts 21,718 21,718 — — Redeemable preferred stock investment 20,438 — — 20,438 Preferred stock of privately held company 15,000 — — 15,000 Municipal bonds 10,553 — 10,553 — Yankee debt securities 693 — 693 — Total equity securities, debt securities and cash equivalents $ 848,669 $ 67,327 $ 745,904 $ 35,438 December 31, 2023 Total Level 1 Level 2 Level 3 (in thousands) Equity securities, debt securities and cash equivalents: U.S. government debt securities $ 365,770 $ — $ 365,770 $ — U.S. agency debt securities 226,717 — 226,717 — Corporate debt securities 75,138 — 75,138 — U.S. treasury bills 69,250 69,250 — — Money market accounts 38,291 38,291 — — Redeemable preferred stock investment 20,438 — — 20,438 Preferred stock of privately held company 15,000 — — 15,000 Municipal bonds 12,685 — 12,685 — Yankee debt securities 692 — 692 — Total equity securities, debt securities and cash equivalents $ 823,981 $ 107,541 $ 681,002 $ 35,438 The Company’s Level 1 assets include U.S. treasury bills and money market instruments and are valued based upon observable market prices. Level 2 assets consist of U.S. government and U.S. agency debt securities, municipal bonds, corporate debt securities and Yankee debt securities. Level 2 securities are valued based upon observable inputs that include reported trades, broker/dealer quotes, bids and offers. As of March 31, 2024, the Company had preferred stock of a privately held company, which was included in other long-term assets in the accompanying Condensed Consolidated Balance Sheets, and redeemable preferred stock of a private company that were measured using unobservable (Level 3) inputs. The fair value of redeemable preferred stock as of March 31, 2024 and December 31, 2023 was based on valuation performed by a third-party valuation company utilizing the guideline public company method under market approach and the discounted cash flow method under income approach. For the value of the investment in private equity securities, the Company elected to measure it at cost minus impairment, as the preferred stock of the privately held company did not have a readily determinable fair value, and no impairment loss was recorded as of March 31, 2024. There were no transfers between fair value measurement levels during the three months ended March 31, 2024 and 2023.

Fixed Assets

Fixed Assets	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Fixed Assets	Note 5. Fixed Assets Major classes of fixed assets consisted of the following: March 31, December 31, Useful Lives 2024 2023 (in thousands) Medical lab equipment 5 months to 12 Years $ 48,493 $ 56,025 Leasehold improvements Shorter of lease term or estimated useful life 10,090 11,222 Building 39 Years 9,781 9,781 Computer software 1 to 5 Years 8,017 7,982 Building improvements 6 months to 39 Years 7,741 7,748 Computer hardware 1 to 5 Years 6,780 6,805 Aircraft 7 Years 6,400 6,400 Furniture and fixtures 1 to 5 Years 3,615 3,860 Land improvements 5 to 15 Years 904 904 Automobile 3 to 7 Years 445 445 General equipment 5 Years 109 115 Land 8,800 8,800 Assets not yet placed in service 22,334 15,010 Total 133,509 135,097 Less: Accumulated depreciation ( 46,786 ) ( 51,633 ) Fixed assets, net $ 86,723 $ 83,464 Depreciation expenses on fixed assets totaled $ 4.6 million and $ 4.7 million for the three months ended March 31, 2024 and 2023, respectively.

Other Significant Balance Sheet

Other Significant Balance Sheet Accounts	3 Months Ended
	Mar. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Other Significant Balance Sheet Accounts	Note 6. Ot her Significant Balance Sheet Accounts Other current assets consisted of the following: March 31, December 31, 2024 2023 (in thousands) Prepaid income taxes $ 7,521 $ 12,675 Prepaid expenses 7,359 7,744 Reagents and supplies 6,528 5,827 Marketable securities interest receivable 6,281 4,994 Other receivable 1,065 1,319 Total $ 28,754 $ 32,559 Accrued liabilities consisted of the following: March 31, December 31, 2024 2023 (in thousands) Accrued legal liabilities $ 7,026 $ 7,026 Payroll liabilities 4,756 5,741 Accrued bonus and commission 4,067 6,255 Vacation accrual 3,765 3,543 Other accrued liabilities 3,394 4,215 Operating lease liabilities - short term 2,910 3,957 Total $ 25,918 $ 30,737 Accrued legal liabilities as of March 31, 2024, and December 31, 2023, included $ 6.9 million in connection with the Company's voluntary disclosure process as described in Note 8, Debt, Commitments, and Contingencies. Other accrued liabilities included short-term finance lease liabilities, health insurance liabilities, and third-party billing services. Other long-term liabilities consisted of the following: March 31, December 31, 2024 2023 (in thousands) Operating lease liabilities, long term $ 6,579 $ 7,147 Other long-term liabilities 4,835 4,973 Notes payable, long term 2,493 2,964 Total $ 13,907 $ 15,084

Reportable Segment and Geograph

Reportable Segment and Geographic Information	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Reportable Segment and Geographic Information	Note 7. Reportable Segment and Geographic Information The Company viewed and managed its operations in one reportable segment prior to December 2023. Given the advancement of the therapeutic development business, the Company made certain changes, including the bifurcation of financial information for the Company’s budget and forecast planning process in December 2023. The CODM manages the operations of the Company and reviews discrete financial information to make resource decisions for its two operating segments separately. These are laboratory services and therapeutic development. The laboratory services operating segment offers technical laboratory services and professional interpretation of laboratory results by licensed physicians who specialize in pathology and oncology. The therapeutic development operating segment is a pharmaceutical research and development entity that the Company acquired in November 2022. Thes e operating segments do not meet the aggregation criteria and therefore represent the Company’s reportable segments. There is no inter-segment allocation of interest expense and income taxes. There is no inter-segment revenue and operating income or loss. Information regarding the Company’s operations and assets for its reportable segments as well as geographic information are as follows: Three Months Ended March 31, 2024 2023 (in thousands) Revenue from services: Laboratory services: Precision diagnostics $ 37,446 $ 27,905 Anatomic pathology 23,107 26,411 BioPharma services 2,656 8,420 COVID-19 1,276 3,432 Total laboratory services 64,485 66,168 Therapeutic development — — Total $ 64,485 $ 66,168 Three Months Ended March 31, 2024 2023 (in thousands) Loss before income taxes: Operating loss Laboratory services $ ( 16,754 ) $ ( 21,603 ) Therapeutic development ( 5,044 ) ( 3,221 ) Total operating loss ( 21,798 ) ( 24,824 ) Interest and other income, net 7,625 3,775 Loss before income taxes $ ( 14,173 ) $ ( 21,049 ) Three Months Ended March 31, 2024 2023 (in thousands) Depreciation and amortization: Laboratory services $ 6,489 $ 6,720 Therapeutic development 174 159 Total $ 6,663 $ 6,879 March 31, December 31, 2024 2023 (in thousands) Assets: Laboratory services $ 1,140,688 $ 1,146,192 Therapeutic development 89,197 89,136 Total $ 1,229,885 $ 1,235,328 Geographic distribution of revenue: Three Months Ended March 31, 2024 2023 (in thousands) Revenue: United States $ 57,850 $ 62,062 Foreign China 4,104 2,088 Other countries 2,531 2,018 Total $ 64,485 $ 66,168 Geographic distribution of property, plant and equipment, net: March 31, December 31, 2024 2023 (in thousands) Fixed assets: Unites States $ 82,168 $ 77,938 Foreign 4,555 5,526 Total $ 86,723 $ 83,464

Debt, Commitments and Contingen

Debt, Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Debt Commitments And Contingencies Disclosure [Abstract]
Debt, Commitments and Contingencies	Note 8. Debt, Commitments, and Contingencies Debt Notes payable as of March 31, 2024, consisted of $ 2.9 million of notes payable related to an installment sale contract the Company entered in February 2022 for a building. The notes payable relate to the installment sale, are due in February 2030, and carry an interest rate of 1.08 % . The current portion and noncurrent portion are $ 413,000 and $ 2.5 million , respectively, and the noncurrent portion is included in the other long-term liabilities in the accompanying Condensed Consolidated Balance Sheets. The Company also had notes payable to Xilong Scientific Co., which were paid off as of March 31, 2024, and had an interest rate of 4.97 % . The interest expenses on all notes payable for the three months ended March 31, 2024 and 2023 were $ 8,000 and $ 75,000 , respectively. Operating Leases See Note 9, Leases , for further information. Purchase Obligations From time to time, the Company enters into certain purchase commitments with its vendors, consisting primarily of services, reagent and supplies, computer software, medical lab equipment, and building assets. As of March 31, 2024, the Company had purchase obligations of $ 57.9 million , $ 39.6 million of which is payable within twelve months, and $ 18.3 million , the remainder, is payable within the next five years. Contingencies From time to time, the Company may be subject to legal proceedings and claims arising in the ordinary course of business. The Company has received a Civil Investigative Demand, or CID, issued by the U.S. Department of Justice pursuant to the False Claims Act related to its investigation of allegations of medically unnecessary laboratory testing, improper billing for laboratory testing, and remuneration received or provided in violation of the Anti-Kickback Statute and the Stark Law. Among other things, this CID requests information and records relating to certain of the Company’s customers named in the CID. As previously disclosed in the Company’s Exchange Act reports, the SEC is also conducting a non-public formal investigation, which appears to relate to the matters raised in the CID requests and its Exchange Act reports filed for 2018 through 2020. The Company is fully cooperating with the U.S. Department of Justice and the SEC to promptly respond to the requests for information in this CID and investigation. The Company cannot predict when these matters will be resolved, the outcome of these matters, or their potential impact, which may materially and adversely affect the Company’s business, prospects, and financial condition. Similar to other laboratories in the industry, the Company is currently being audited by the U.S. Health Resources and Services Administration, or HRSA, with respect to its reimbursement for COVID-19 tests furnished to patients believed to be uninsured. The Company recorded approximately $ 548.9 million of reimbursements from HRSA under the Uninsured Program during the years ending December 31, 2022, 2021, and 2020. The Company is fully cooperating and working with HRSA’s auditors to resolve any issues, including any reimbursed amounts that may need to be returned to HRSA. There is uncertainty with respect to the methodology HRSA will use and whether and how they will extrapolate audit results. The results of the HRSA audit may materially and adversely affect the Company’s business, prospects, and financial condition. The Company cannot reasonably estimate the loss or range of loss, if any, that may result from any material government investigations, audits, and reviews in which it is currently involved, given the inherent difficulty in predicting regulatory action, fines and penalties, if any, and the various remedies and levels of judicial review available to the Company in the event of an adverse finding. As a result, the Company has not recorded any liability related to these matters. In relation to a recent advisory opinion issued by the Office of Inspector General of the Department of Health and Human Services, the Company’s subsidiary, Symphony Buyer, Inc., or Inform Diagnostics, initiated a voluntary disclosure process with the appropriate government contact. The Company currently has estimated and recorded $ 6.9 million as a liability in its financial statements in connection with this voluntary disclosure. This estimate may be incorrect, and the actual amount of liability may be lower or may materially exceed this estimate.

Leases

Leases	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Leases	Note 9. Leases Lessee The Company is a lessee to various non-cancelable operating leases with varying terms through April 2033 primarily for laboratory and office space and equipment. The Company has options to renew some of these leases after their expirations. On a lease-by-lease basis, the Company considers such options, which may be elected at the Company’s sole discretion, in determining the lease term. The Company also has various finance leases for lab equipment with varying terms through December 2026 , some of which were acquired in business combinations. The Company does not have any leases with variable lease payments. The Company’s operating lease agreements do not contain any residual value guarantees, material restrictive covenants, bargain purchase options, or asset retirement obligations. The Company’s headquarters are located in El Monte, California, which is comprised of various corporate offices and a laboratory certified under the Clinical Laboratory Improvement Amendments of 1988, or CLIA, accredited by the College of American Pathologists, or CAP, and licensed by the State of California Department of Public Health. Other CLIA-certified laboratories are located in Irving, Texas; Needham, Massachusetts; Phoenix, Arizona; Alpharetta, Georgia; and New York, New York. The operating and finance lease right-of-use asset, short-term lease liabilities, and long-term lease liabilities as of March 31, 2024, and December 31, 2023, were as follows: March 31, December 31, 2024 2023 (in thousands) Operating lease ROU asset, net $ 9,225 $ 10,838 Operating lease liabilities, short term $ 2,910 $ 3,957 Operating lease liabilities, long term $ 6,579 $ 7,147 Finance lease ROU asset, net $ 1,175 $ 1,316 Finance lease liabilities, short term $ 543 $ 544 Finance lease liabilities, long term $ 622 $ 760 The following were operating and finance lease expenses: Three Months Ended March 31, 2024 2023 (in thousands) Operating lease cost $ 1,629 $ 1,702 Finance lease cost: Amortization of ROU assets 137 243 Interest on lease liabilities 12 27 Short-term lease cost 316 501 Total lease cost $ 2,094 $ 2,473 Supplemental information related to operating and finance leases were the following: March 31, 2024 Weighted average remaining lease term - operating leases 4.57 years Weighted average discount rate - operating leases 3.98 % Weighted average remaining lease term - finance lease 2.48 years Weighted average discount rate - finance lease 3.68 % The following is a maturity analysis of operating and finance lease liabilities using undiscounted cash flows on an annual basis with renewal periods included: Operating Leases Finance Lease (in thousands) Year Ending December 31, 2024 (remaining 9 months) $ 2,626 $ 383 2025 2,351 468 2026 1,777 366 2027 1,687 — 2028 544 — 2029 347 — Thereafter 1,178 — Total lease payments 10,510 1,217 Less imputed interest ( 1,021 ) ( 52 ) Total $ 9,489 $ 1,165 Lessor The Company leases out space in buildings it owns and leases to third-party tenants under noncancelable operating leases. As of March 31, 2024, the remaining lease term is 9 months, including renewal options and may include rent escalation clauses. Lease income primarily represents fixed lease payments from tenants recognized on a straight-line basis over the application lease term. Variable lease income represents tenant payments for real estate taxes, insurance, and maintenance. The lease income was included in interest and other income, net, in the accompanying Condensed Consolidated Statements of Operations. Total lease income was as follows: Three Months Ended March 31, 2024 2023 (in thousands) Lease income $ 17 $ 45 Total lease income $ 17 $ 45 Future fixed lease payments from tenants for all noncancelable operating leases as of March 31, 2024 are as follows: Lease Payments from Tenants (in thousands) Year Ending December 31, 2024 (remaining 9 months) $ 68 Total $ 68

Equity-Based Compensation

Equity-Based Compensation	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Equity-Based Compensation	Note 10. Equity-Based Compensation The Company has included equity-based compensation expense as part of cost of revenue and operating expenses in the accompanying Condensed Consolidated Statements of Operations as follows: Three Months Ended March 31, 2024 2023 (in thousands) Cost of revenue $ 2,009 $ 2,394 Research and development 3,844 3,448 Selling and marketing 1,050 1,361 General and administrative 4,615 3,062 Total $ 11,518 $ 10,265

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2024
Income Tax Disclosure [Abstract]
(Benefit from) Provision for Income Taxes	Note 11. Income Taxes The effective tax rate used for interim periods is the estimated annual effective consolidated tax rate, based on the current estimate of full year results, except that taxes related to specific events, if any, are recorded in the interim period in which they occur. The annual effective tax rate is based upon several significant estimates and judgments, including the estimated annual pre-tax income (loss) of the Company in each tax jurisdiction in which it operates, and the development of tax planning strategies during the year. In addition, the Company’s tax expense can be impacted by changes in tax rates or laws and other factors that cannot be predicted with certainty. As such, there can be significant volatility in interim tax provisions. The Company recorded consolidated benefit from income taxes of $ 327,000 and $ 5.2 million for the three months ended March 31, 2024 and 2023, respectively. The Company’s effective tax rate was 2 % for the three months ended March 31, 2024, compared with 25 % for the three months ended March 31, 2023. The change in the effective tax rate compared to prior period is due to the valuation allowance in the current period that precludes the Company from recognizing the benefit from net operating losses. The Company is under examination by certain tax authorities for the 2020 to 2021 tax years. While the timing of the conclusion of the examination is uncertain, the Company believes that adequate amounts have been reserved for adjustments that may result. During 2024, the statutes of limitations will lapse on the Company’s 2020 federal tax year and certain 2019 and 2020 state tax years. The Company does not believe the federal or state statute lapses or any other event will significantly impact the balance of unrecognized tax benefits in the next twelve months. The Company received $ 6.2 million and $ 657,000 income tax refunds in the three months ended March 31, 2024 and 2023, respectively, and income tax refunds received were not netted in the income tax paid amounts included in the supplemental disclosure in the accompanying Condensed Consolidated Statements of Cash Flows.

Loss per Share

Loss per Share	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Loss per Share	Note 12. Loss per Share The following table presents the calculation of basic and diluted loss per share for the three months ended March 31, 2024 and 2023: Three Months Ended March 31, 2024 2023 (in thousands, except per share data) Net loss attributable to common shareholders $ ( 13,462 ) $ ( 15,340 ) Weighted-average common shares - outstanding, basic 29,769 29,536 Weighted-average common shares - outstanding, diluted 29,769 29,536 Loss per share: Basic $ ( 0.45 ) $ ( 0.52 ) Diluted $ ( 0.45 ) $ ( 0.52 ) The following securities have been excluded from the calculation of diluted loss per share because their effect would have been anti-dilutive: Three Months Ended March 31, 2024 2023 (in thousands) Options 222 211 Restricted Stock Units 2,199 2,040 Contingently Issuable Shares 186 371 The anti-dilutive shares described above were calculated using the treasury stock method. In the three months ended March 31, 2024 and 2023, the Company had outstanding stock options and restricted stock units and contingently issuable shares for shares held back in connection with the business combination of Fulgent Pharma that were excluded from the weighted-average share calculation for continuing operations due to the Company’s net loss positions.

Related Parties

Related Parties	3 Months Ended
	Mar. 31, 2024
Related Party Transactions [Abstract]
Related Parties	Note 13. Related Parties Linda Marsh, who is a member of the Company’s Board of Directors, or the Board, is currently the Senior Executive Vice President of AHMC Healthcare Inc., or AHMC. The Company performs genetic testing and other testing services, on an arms-length basis for AHMC , and the Company recognized $ 95,000 in revenue from AHMC in the three months ended March 31, 2023. The revenue recognized for the three months ended March 31, 2024, was insignificant. As of March 31, 2024, and December 31, 2023, $ 11,000 and $ 13,000 , respectively, was owed to the Company by AHMC , which is included in trade accounts receivable, net, in the accompanying Condensed Consolidated Balance Sheets, in connection with this relationship. Ming Hsieh, the Chief Executive Officer and Chairperson of the Board, is on the board of directors and an approximately 20 % owner of ANP, from which the Company entered into certain drug-related licensing and development service agreements. The Chief Executive Officer of Fulgent Pharma, Ray Yin, is the Founder, President and Chief Technology Officer of ANP. The Company incurred $ 651,000 and $ 959,000 related to the licensing and development services in the three months ended March 31, 2024 and 2023, respectively. As of March 31, 2024, and December 31, 2023, $ 193,000 and zero , respectively, were owed to ANP by the Company in connection with these relationships. The Company also entered into an employee service agreement with ANP in April 2023 and recognized $ 77,000 and zero in revenue in the three months ended March 31, 2024 and 2023, respectively, and $ 56,000 and $ 29,000 was owed to the Company by ANP in connection with the employee service agreement as of March 31, 2024 and December 31, 2023, respectively.

Goodwill and Acquisition-Relate

Goodwill and Acquisition-Related Intangibles	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Acquisition-Related Intangibles	Note 14. Goodwill and Acquisition-Related Intangibles There was no change in the carrying amount in the three months ended March 31, 2024. Goodwill, net, as of March 31, 2024 and December 31, 2023 by reporting unit was as follows: March 31, December 31, 2024 2023 (in thousands) Goodwill: Laboratory services $ — $ — Therapeutic development 22,055 22,055 Total $ 22,055 $ 22,055 The Company has identified its laboratory services business and its therapeutic development business as its two operating segments, and the Company determined that the two operating segments represented the two reporting units. The Company tests for goodwill impairment at the reporting unit level on December 31st of each year and more frequently if events or circumstances indicate a potential impairment. Laboratory Services The Company recognized a full goodwill impairment loss for the goodwill of its laboratory services reporting unit as of December 31, 2023 due to a continued decline in its share price and market capitalization. Therapeutic Development Based upon the results of the quantitative assessments the Company performed as of December 31, 2023, the Company concluded that the fair values of the therapeutic development reporting unit and the IPR&D asset, at December 31, 2023, were greater than the carrying values and that there was no impairment. There have been no significant changes in the three months ended March 31, 2024. There can be no assurance that the estimates and assumptions management made for the purposes of the goodwill or IPR&D impairment analysis will prove to be accurate predictions of future performance. It is possible that the conclusions regarding impairment or recoverability of goodwill or intangible assets could change in future periods. Management will continue to monitor the therapeutic development reporting unit. For all IPR&D projects, there are major risks and uncertainties associated with the timely and successful completion of development and commercialization of these product candidates, including the ability to confirm their efficacy based on data from clinical trials, the ability to obtain necessary regulatory approvals, and the ability to successfully complete these tasks within budgeted costs. The Company is not able to market a human therapeutic without obtaining regulatory approvals, and such approvals require completing clinical trials that demonstrate a product candidate is safe and effective. In addition, the availability and extent of coverage and reimbursement from third-party payors, including government healthcare programs and private insurance plans, impact the revenues a product can generate. Consequently, the eventual realized value, if any, of these acquired IPR&D projects may vary from their estimated fair values. Summaries of intangible asset balances as of March 31, 2024 and December 31, 2023 were as follows: March 31, December 31, Weighted-Average Amortization Period 2024 2023 (in thousands) Laboratory Services: Royalty-free technology 10 Years $ 5,124 $ 5,211 Less: accumulated amortization ( 1,495 ) ( 1,390 ) Royalty-free technology, net 3,629 3,821 Customer Relationships 13 Years 83,101 83,119 Less: accumulated amortization ( 14,204 ) ( 12,586 ) Customer relationships, net 68,897 70,533 Trade name 8 Years 3,790 3,790 Less: accumulated amortization ( 1,030 ) ( 906 ) Trade name, net 2,760 2,884 In-place lease intangible assets 5 Years 360 360 Less: accumulated amortization ( 134 ) ( 116 ) In-place lease intangible assets, net 226 244 Laboratory information system platform 5 Years 1,860 1,860 Less: accumulated amortization ( 992 ) ( 899 ) Laboratory information system platform, net 868 961 Purchased patent 10 Years 28 28 Less: accumulated amortization ( 9 ) ( 8 ) Purchased patent, net 19 20 Total 76,399 78,463 Therapeutic Development: In-process research & development n/a 64,590 64,590 Total 64,590 64,590 Total intangible assets, net $ 140,989 $ 143,053 Acquisition-related intangibles included in the above tables are generally finite-lived and are carried at cost less accumulated amortization, except for IPR&D, which is related to the business combination of Fulgent Pharma in 2022 and has an indefinite life until research and development efforts are completed or abandoned. All other finite-lived acquisition-related intangibles related to the business combinations in 2022 and 2021 are amortized on a straight-line basis over their estimated lives, which approximates the pattern in which the economic benefits of the intangible assets are expected to be realized. Amortization of intangible assets was $ 2.0 million in each of the three months ended March 31, 2024 and 2023. Based on the carrying value of finite-lived intangible assets recorded as of March 31, 2024, and assuming no subsequent impairment of the underlying assets, the annual amortization expense for intangible assets is expected to be as follows: Amounts (in thousands) Year Ending December 31, 2024 (remaining 9 months) $ 5,973 2025 7,963 2026 7,661 2027 7,201 2028 7,166 2029 6,909 Thereafter 33,526 Total $ 76,399

Stock Repurchase Program

Stock Repurchase Program	3 Months Ended
	Mar. 31, 2024
Stockholders' Equity Note [Abstract]
Stock Repurchase Program	Note 15. Stock Repurchase Program In March 2022, the Board authorized a $ 250.0 million stock repurchase program. Under the stock repurchase program, the Company may repurchase shares from time to time in the open market or in privately negotiated transactions. The stock repurchase program has no expiration from the date of authorization. During the three months ended March 31, 2024, the Company repurchased 10,000 shares of its common stock at an aggregate cost of $ 225,000 under the stock repurchase program . During the three months ended March 31, 2023, the Company did no t repurchase any shares of its common stock. As of March 31, 2024, a total of approximately $ 150.5 million remained available for future repurchases under the stock repurchase program.

Retirement Plans

Retirement Plans	3 Months Ended
	Mar. 31, 2024
Retirement Benefits [Abstract]
Retirement Plans	Note 16. Retirement Plans The Company offers a 401(k) retirement savings plan, or the 401(k) Plan, for its employees, including its executive officers, who satisfy certain eligibility requirements. The Internal Revenue Code of 1986, as amended, allows eligible employees to defer a portion of their compensation, within prescribed limits, on a pre-tax basis through contributions to the 401(k) Plan. The Company matches contributions to the 401(k) Plan based on the amount of salary deferral contributions the participant makes to the 401(k) Plan. The Company provides safe harbor match of the employee contribution to his or her 401(k) Plan account. Total Company matching contributions to the 401(k) Plan were $ 1.0 million for each of the three months ended March 31, 2024 and 2023.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2024
Subsequent Events [Abstract]
Subsequent Events	Note 17. Subsequent Events As of May 3, 2024, no subsequent events are being reported.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Use of Estimates	Use of Estimates The preparation of condensed consolidated financial statements in conformity with U.S. GAAP requires management to make certain estimates, judgments and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements, as well as the reported amounts of revenue and expenses during the reporting periods. These estimates, judgments and assumptions are based on historical data and experience available at the date of the accompanying condensed consolidated financial statements, as well as various other factors management believes to be reasonable under the circumstances. The Company’s estimates and assumptions may evolve as conditions change. Actual results could differ significantly from these estimates. On an on-going basis, management evaluates its estimates, primarily those related to: (i) revenue recognition criteria, (ii) accounts receivable and allowances for credit losses, (iii) the useful lives of fixed assets and intangible assets, (iv) estimates of tax liabilities, (v) valuation of intangible assets and goodwill at time of acquisition and on a recurring basis, and (vi) valuation of investments.
Trade Accounts Receivable and Allowance for Credit Losses	Trade Accounts Receivable and Allowance for Credit Losses Trade accounts receivable are stated at the amount the Company expects to collect. The Company maintains an allowance for credit losses for expected uncollectible trade accounts receivable, which is recorded as an offset to trade accounts receivable, and changes in allowance for credit losses are classified as a general and administrative expense in the accompanying Condensed Consolidated Statements of Operations. The Company assesses collectability by reviewing trade accounts receivable on a collective basis where similar risk characteristics exist and on an individual basis when it identifies specific customers that have deterioration in credit quality such that they may no longer share similar risk characteristics with the other receivables. In determining the amount of the allowance for credit losses, the Company uses a loss rate model or probability-of-default and loss given default model. Following the loss rate method, expected credit losses are determined based on an estimated historical loss rate. The probability of default method allows the ability to define a point of default and measure credit losses for receivables that have reached the point of default for purposes of calculating the allowance for credit losses. Loss given default represents the likelihood that a receivable that has reached the point of default will not be collected in full. The Company updates its loss rate and factors annually to incorporate the most recent historical data and adjusts the quantitative portion of the reserve through its qualitative reserve overlay. The Company looks at qualitative factors such as general economic conditions in determining expected credit losses. The roll-forward for the allowance for credit losses for the three months ended March 31, 2024, dollars in thousands, is as follows: Allowance for credit losses at beginning of year $ 25,226 Current period provision ( 2,497 ) Write-downs ( 1,336 ) Recoveries of amounts previously charged off 4,438 Allowance for credit losses as of March 31, 2024 $ 25,831
Redeemable Preferred Stock Investment	Redeemable Preferred Stock Investment The redeemable preferred stock investment of $ 20.4 million as of March 31, 2024 represents the fair value of redeemable preferred stock of a private company that the Company purchased in July 2021. The investment is classified as available-for-sale debt securit ies. The fair value of available-for-sale debt security is included in the Condensed Consolidated Statement of Balance Sheets. Unrealized gain of $ 597,000 was ex cluded from earnings and reported in other comprehensive loss in the three months ended March 31, 2023, and there was no unrealized gain or loss in the three months ended March 31, 2024. Since the Company intends on holding the preferred stock, and the preferred stock is not redeemable until July 2027 , the investment is recorded as a long-term investment.
Finite-Lived Intangible assets	Finite-Lived Intangible assets Intangible assets, unless determined to be indefinite-lived, are amortized over their estimated useful lives. The Company amortizes intangible assets on a straight-line basis with definite lives generally over periods ranging from three to fourteen years . See Note 14, Goodwill and Acquisition-Related Intangibles , for details of intangible assets.
Impairment of Long-Lived Assets	Impairment of Long-Lived Assets The Company evaluates the carrying amount of its long-lived assets whenever events or changes in circumstances indicate that the assets may not be recoverable. An impairment loss would be recognized when estimated future cash flows expected to result from the use of an asset and its eventual disposition is less than the carrying amount of the asset.
Goodwill and Indefinite-Lived Intangibles	Goodwill and Indefinite-Lived Intangibles Intangibles in-process research & development costs, or IPR&D, are considered to be indefinite-lived until the completion or abandonment of the associated research and development efforts. If and when development is complete, the associated assets would be deemed finite-lived and would then be amortized based on their respective estimated useful lives at that point in time. The Company assesses goodwill and indefinite-lived intangibles for impairment on an annual basis and between annual tests if an event occurs or circumstances change that would more likely than not reduce the fair value of a reporting unit below its carrying amount. The Company may choose to bypass a qualitative assessment of impairment for any reporting unit and proceed directly to performing a quantitative assessment. An impairment loss would be recognized for the amount by which the reporting unit's carrying amount exceeds its fair value. The Company’s quantitative assessment includes estimating the fair value of each reporting unit and comparing it to its carrying value. The Company estimates the fair value of reporting units using both income-based and market-based valuation methods and typically engages a third-party appraisal firm to assist with the valuation. The estimated fair value for each reporting unit is determined based upon the range of estimated values developed from the income and market-based methods. If the estimated fair value of a reporting unit exceeds its carrying value, the goodwill is not impaired, and no further review is required. The income-based fair value methodology is based on a reporting unit’s forecasted future cash flows that are discounted to the present value using the reporting unit’s weighted average cost of capital. Under the income-based approach, it requires management's assumptions and judgments regarding economic conditions in the markets in which the company operates and conditions in the capital markets, many of which are outside of management's control. The market-based fair value methodology looks at the guideline public company valuation method to determine the prices of comparable public companies and looks at merger and acquisition methods, similar businesses that were sold recently, to estimate the value of the reporting units. Under the market-based approach, judgment is required in evaluating market multiples and recent transactions.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The Company’s financial instruments consist principally of cash and cash equivalents, marketable securities, trade accounts receivable, redeemable preferred stock investment, accounts payable, and accrued liabilities. The carrying amounts of certain of these financial instruments, including cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities approximate fair value due to their short maturities. Fair value of marketable securities and redeemable preferred stock investment is disclosed in Note 4, Fair Value Measurements , to the accompanying consolidated financial statements.
Concentrations of Credit Risk, Customers and Suppliers	Concentrations of Credit Risk, Customers, and Suppliers Financial instruments that potentially subject the Company to significant concentrations of credit risk consist primarily of cash and cash equivalents, trade accounts receivable, and marketable securities, which consist of debt securities and equity securities. As of March 31, 2024, substantially all of the Company’s cash and cash equivalents were deposited in accounts at financial institutions, and amounts may exceed federally insured limits. Management believes that the Company is not exposed to significant credit risk due to the financial strength of the depository institutions in which its cash and cash equivalents are held. In certain periods, a small number of customers has accounted for a significant portion of the Company’s revenue. For the laboratory services business, aggregating customers under common control, one customer comprised of $ 12.6 million or 20 % of total revenue in the three months ended as of March 31, 2024. No customer contributed 10 % or more of the Company's revenue in the three months ended March 31, 2023. One customer comprised 12 % of total accounts receivable, net, as of March 31, 2024, and comprised 13 % of total accounts receivable, net, as of December 31, 2023. For the therapeutic development business, as of March 31, 2024 and December 31, 2023, there is no concentration risk, as there are no customers or revenue, as it does not have any commercialized or approved product candidates. The Company relies on a limited number of suppliers for certain laboratory substances used in the chemical reactions incorporated into its processes, referred to as reagents, as well as for the sequencers and various other equipment and materials it uses in its laboratory operations. In particular, the Company relies on a sole supplier for the next generation sequencers and associated reagents it uses to perform its genetic tests and as the sole provider of maintenance and repair services for these sequencers. The operations of the laboratory services business would be interrupted if it encountered delays or difficulties securing these reagents, sequencers, other equipment or materials or maintenance and repair services, which could occur for a variety of reasons, including if the Company needs a replacement or temporary substitute for any of its limited or sole suppliers and is not able to locate and make arrangements with an acceptable replacement or temporary substitute. The Company's development efforts could also be delayed or interrupted if is unable to procure items needed for its therapeutic development activities. The Company’s therapeutic development business also relies on ANP Technologies, Inc., or ANP, for certain laboratory services, equipment, tools, and drug intermediates in connection with research and development efforts. The Company believes there are currently only a few other manufacturers that are capable of supplying and servicing some of the equipment and other materials necessary for its laboratory operations, including collection kits, sequencers and various associated reagents.
Reportable Segment and Geographic Information	Reportable Segment and Geographic Information Reportable segments are identified as components of an enterprise about which separate discrete financial information is available for evaluation by the chief operating decision-maker, or CODM, in making decisions regarding resource allocation and assessing performance. The Company’s CODM is its Chief Executive Officer. The Company reports its business in two segments, a laboratory services business and a therapeutic development business. For further financial information about these segments, including information for each of the periods presented regarding revenue, operating income (loss), and other important information, see Note 7, Reportable Segment and Geographic Information .
Foreign Currency Translation and Foreign Currency Transactions	Foreign Currency Translation and Foreign Currency Transactions The Company translates the assets and liabilities of its non-U.S. dollar functional currency subsidiaries into U.S. dollars using exchange rates in effect at the end of each period. Expenses for these subsidiaries are translated using rates that approximate those in effect during the period. Gains and losses from these translations are recognized in foreign currency translation included in accumulated other comprehensive (loss) income in the accompanying Condensed Consolidated Statements of Stockholders’ Equity. The Company and its subsidiaries that use the U.S. dollar as their functional currency remeasure monetary assets and liabilities at exchange rates in effect at the end of each period, and inventories, property and nonmonetary assets and liabilities are measured at historical rates. Losses from these remeasurements were not significant in the three months ended March 31, 2024 and 2023.
Comprehensive Income (Loss)	Comprehensive Income (Loss) Comprehensive income (loss) is comprised of net income (loss) and other comprehensive income (loss). Other comprehensive income (loss) consists of net unrealized gain or loss on available-for-sale debt securities, net of tax, and foreign currency translation adjustments from the Company's subsidiaries not using the U.S. dollar as their functional currency. There were no reclassifications from other comprehensive income (loss) to net loss in the three months ended March 31, 2024 or 2023. The tax effect related to net unrealized losses on available-for-sale debt securities was zero for the three months ended March 31, 2024 due to the valuation allowance in the current period that precludes the Company from recognizing the deferred tax benefit. The tax effect related to net unrealized losses was $ 1.9 million for the three months ended March 31, 2023.
Disaggregation of Revenue	Disaggregation of Revenue The Company classifies its customers into three payor types: (i) Insurance, (ii) Institutions, including hospitals, medical institutions, other laboratories, governmental bodies, municipalities and large corporations, or (iii) Patients who pay directly. The Company believes these classifications best depict how the nature, amount, timing, and uncertainty of its revenue and cash flows are affected by economic factors. The following table summarizes revenue from contracts with customers by payor type for the three months ended March 31, 2024 and 2023. Three Months Ended March 31, 2024 2023 (in thousands) Testing Services by Payor Institutional $ 33,604 $ 30,992 Insurance 30,043 34,551 Patient 838 625 Total Revenue $ 64,485 $ 66,168 $ 1.2 million variable consideration was recognized in the three months ended March 31, 2024, that related to COVID-19 tests completed in the prior periods due to the recent collection efforts, which was included as revenue from insurance in the table above. During the three months ended March 31, 2024, the Company experienced a change in estimate related to variable consideration. The Company estimates variable consideration using the expected value method. Any changes in variable consideration estimates that affect transactions are accounted for on a cumulative catch-up basis. There was no material variable consideration recognized in the three months ended March 31, 2023. Contract Balances Receivables from contracts with customers - Receivables from contracts with customers are included within trade accounts receivable on the Condensed Consolidated Balance Sheets. Receivables from Insurance and Institutional customers represented 43 % and 57 % , respectively, as of March 31, 2024 and 39 % and 61 %, respectively, as of December 31, 2023. Contracts assets and liabilities - Contract assets from contracts with customers associated with contract execution and certain costs to fulfill a contract are included in other current assets in the accompanying Condensed Consolidated Balance Sheets. Contract liabilities are recorded when the Company receives payment prior to completing its obligation to transfer goods or services to a customer. Contract liabilities are included in the Condensed Consolidated Balance Sheets. Revenues of $ 860,000 and $ 1.3 million were recognized for the three months ended March 31, 2024 and 2023, respectively, related to contract liabilities at the beginning of the respective periods.
Recent Accounting Pronouncements	Recent Accounting Pronouncements The Company evaluates all Accounting Standards Updates, or ASUs, issued by the Financial Accounting Standards Board, or FASB, for consideration of their applicability. ASUs not included in the Company’s disclosures were assessed and determined to be either not applicable or are not expected to have a material impact on the Company’s condensed consolidated financial statements. In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280), Improvements to Reportable Segments. This update improves reportable segment disclosure requirements and requires enhanced disclosures related to significant segment expenses regularly provided to CODM, the amount for other segment items with descriptions of the composition, segment profit or loss, and clarification on if the CODM uses more than one measurement of a segment's profit or loss in assessing segment performance and deciding how to allocate resources. Amendments in this update are effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. The Company is currently evaluating the impacts of this amendment on the consolidated financial statements and related disclosure. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvement to Income Tax Disclosures. The update requires more detailed information on certain income tax disclosures including the income tax rate reconciliation and income taxes paid. Amendments in this update are effective for annual periods beginning December 15, 2024 for public entities, and early adoption is permitted. The Company is currently evaluating the impacts of this amendment on the consolidated financial statements and related disclosure. The Company does not expect that any other recently issued accounting guidance will have a significant effect on its consolidated financial statements.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	3 Months Ended
	Mar. 31, 2024
Roll-Forward for Allowance for Credit Losses	The roll-forward for the allowance for credit losses for the three months ended March 31, 2024, dollars in thousands, is as follows: Allowance for credit losses at beginning of year $ 25,226 Current period provision ( 2,497 ) Write-downs ( 1,336 ) Recoveries of amounts previously charged off 4,438 Allowance for credit losses as of March 31, 2024 $ 25,831
Accounting Standards Update 2014-09
Summary of Revenue from Contracts with Customers by Payor Type	The following table summarizes revenue from contracts with customers by payor type for the three months ended March 31, 2024 and 2023. Three Months Ended March 31, 2024 2023 (in thousands) Testing Services by Payor Institutional $ 33,604 $ 30,992 Insurance 30,043 34,551 Patient 838 625 Total Revenue $ 64,485 $ 66,168

Equity and Debt Securities (Tab

Equity and Debt Securities (Tables)	3 Months Ended
	Mar. 31, 2024
Investments, Debt and Equity Securities [Abstract]
Summary of Equity and Debt Securities	The Company’s equity and debt securities consisted of the following: March 31, 2024 Amortized Unrealized Unrealized Aggregate (in thousands) Equity securities: Long-term Preferred stock of privately held company $ 15,000 $ — $ — $ 15,000 Total equity securities 15,000 — — 15,000 Available-for-sale debt securities Short-term U.S. government debt securities 106,187 — ( 1,059 ) 105,128 U.S. agency debt securities 57,328 — ( 1,071 ) 56,257 U.S. treasury bills 45,613 — ( 4 ) 45,609 Corporate debt securities 39,655 — ( 299 ) 39,356 Money market accounts 21,718 — — 21,718 Municipal bonds 4,696 — ( 28 ) 4,668 Less: Cash equivalents ( 21,718 ) — — ( 21,718 ) Total debt securities due within 1 year 253,479 — ( 2,461 ) 251,018 After 1 year through 5 years U.S. government debt securities 345,156 284 ( 2,102 ) 343,338 U.S. agency debt securities 151,721 5 ( 1,412 ) 150,314 Corporate debt securities 41,025 — ( 760 ) 40,265 Redeemable preferred stock investment 20,000 438 — 20,438 Municipal bonds 5,061 1 ( 35 ) 5,027 Yankee debt securities 752 — ( 59 ) 693 Total debt securities due after 1 year through 5 years 563,715 728 ( 4,368 ) 560,075 After 5 years through 10 years Municipal bonds 864 1 ( 7 ) 858 Total debt securities due after 5 years through 10 years 864 1 ( 7 ) 858 Total available-for-sale debt securities 818,058 729 ( 6,836 ) 811,951 Total equity and debt securities $ 833,058 $ 729 $ ( 6,836 ) $ 826,951 December 31, 2023 Amortized Unrealized Unrealized Aggregate (in thousands) Equity securities: Long-term Preferred stock of privately held company $ 15,000 $ — $ — $ 15,000 Total equity securities 15,000 — — 15,000 Available-for-sale debt securities Short-term U.S. government debt securities 119,739 8 ( 1,765 ) 117,982 U.S. agency debt securities 72,310 — ( 1,414 ) 70,896 U.S. treasury bills 69,214 36 — 69,250 Corporate debt securities 63,810 — ( 792 ) 63,018 Money market accounts 38,291 — — 38,291 Municipal bonds 5,557 1 ( 23 ) 5,535 Less: Cash equivalents ( 38,291 ) — — ( 38,291 ) Total debt securities due within 1 year 330,630 45 ( 3,994 ) 326,681 After 1 year through 5 years U.S. government debt securities 247,104 1,262 ( 578 ) 247,788 U.S. agency debt securities 156,150 161 ( 490 ) 155,821 Corporate debt securities 12,885 — ( 765 ) 12,120 Municipal bonds 6,337 2 ( 48 ) 6,291 Yankee debt securities 752 — ( 60 ) 692 Redeemable preferred stock investment 20,000 438 — 20,438 Total debt securities due after 1 year through 5 years 443,228 1,863 ( 1,941 ) 443,150 After 5 years through 10 years Municipal bonds 868 1 ( 10 ) 859 Total debt securities due after 5 years through 10 years 868 1 ( 10 ) 859 Total available-for-sale debt securities 774,726 1,909 ( 5,945 ) 770,690 Total equity and debt securities $ 789,726 $ 1,909 $ ( 5,945 ) $ 785,690

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Information about Financial Assets Measured at Fair Value on Recurring Basis Based on Three-Tier Fair Value Hierarchy	The following tables present information about the Company’s financial assets measured at fair value on a recurring basis, based on the above three-tier fair value hierarchy: March 31, 2024 Total Level 1 Level 2 Level 3 (in thousands) Equity securities, debt securities and cash equivalents: U.S. government debt securities $ 448,466 $ — $ 448,466 $ — U.S. agency debt securities 206,571 — 206,571 — Corporate debt securities 79,621 — 79,621 — U.S. treasury bills 45,609 45,609 — — Money market accounts 21,718 21,718 — — Redeemable preferred stock investment 20,438 — — 20,438 Preferred stock of privately held company 15,000 — — 15,000 Municipal bonds 10,553 — 10,553 — Yankee debt securities 693 — 693 — Total equity securities, debt securities and cash equivalents $ 848,669 $ 67,327 $ 745,904 $ 35,438 December 31, 2023 Total Level 1 Level 2 Level 3 (in thousands) Equity securities, debt securities and cash equivalents: U.S. government debt securities $ 365,770 $ — $ 365,770 $ — U.S. agency debt securities 226,717 — 226,717 — Corporate debt securities 75,138 — 75,138 — U.S. treasury bills 69,250 69,250 — — Money market accounts 38,291 38,291 — — Redeemable preferred stock investment 20,438 — — 20,438 Preferred stock of privately held company 15,000 — — 15,000 Municipal bonds 12,685 — 12,685 — Yankee debt securities 692 — 692 — Total equity securities, debt securities and cash equivalents $ 823,981 $ 107,541 $ 681,002 $ 35,438

Fixed Assets (Tables)

Fixed Assets (Tables)	3 Months Ended
	Mar. 31, 2024
Property, Plant and Equipment [Abstract]
Major Classes of Fixed Assets	Major classes of fixed assets consisted of the following: March 31, December 31, Useful Lives 2024 2023 (in thousands) Medical lab equipment 5 months to 12 Years $ 48,493 $ 56,025 Leasehold improvements Shorter of lease term or estimated useful life 10,090 11,222 Building 39 Years 9,781 9,781 Computer software 1 to 5 Years 8,017 7,982 Building improvements 6 months to 39 Years 7,741 7,748 Computer hardware 1 to 5 Years 6,780 6,805 Aircraft 7 Years 6,400 6,400 Furniture and fixtures 1 to 5 Years 3,615 3,860 Land improvements 5 to 15 Years 904 904 Automobile 3 to 7 Years 445 445 General equipment 5 Years 109 115 Land 8,800 8,800 Assets not yet placed in service 22,334 15,010 Total 133,509 135,097 Less: Accumulated depreciation ( 46,786 ) ( 51,633 ) Fixed assets, net $ 86,723 $ 83,464

Other Significant Balance She_2

Other Significant Balance Sheet Accounts (Tables)	3 Months Ended
	Mar. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Schedule of Other Current Assets	Other current assets consisted of the following: March 31, December 31, 2024 2023 (in thousands) Prepaid income taxes $ 7,521 $ 12,675 Prepaid expenses 7,359 7,744 Reagents and supplies 6,528 5,827 Marketable securities interest receivable 6,281 4,994 Other receivable 1,065 1,319 Total $ 28,754 $ 32,559
Schedule of Accrued Liabilities	Accrued liabilities consisted of the following: March 31, December 31, 2024 2023 (in thousands) Accrued legal liabilities $ 7,026 $ 7,026 Payroll liabilities 4,756 5,741 Accrued bonus and commission 4,067 6,255 Vacation accrual 3,765 3,543 Other accrued liabilities 3,394 4,215 Operating lease liabilities - short term 2,910 3,957 Total $ 25,918 $ 30,737
Schedule of Other Long-Term Liabilities	Other long-term liabilities consisted of the following: March 31, December 31, 2024 2023 (in thousands) Operating lease liabilities, long term $ 6,579 $ 7,147 Other long-term liabilities 4,835 4,973 Notes payable, long term 2,493 2,964 Total $ 13,907 $ 15,084

Reportable Segment and Geogra_2

Reportable Segment and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2024
Segment Reporting [Abstract]
Schedule of Information Regarding Operations and Assets for Operating Segments	Information regarding the Company’s operations and assets for its reportable segments as well as geographic information are as follows: Three Months Ended March 31, 2024 2023 (in thousands) Revenue from services: Laboratory services: Precision diagnostics $ 37,446 $ 27,905 Anatomic pathology 23,107 26,411 BioPharma services 2,656 8,420 COVID-19 1,276 3,432 Total laboratory services 64,485 66,168 Therapeutic development — — Total $ 64,485 $ 66,168 Three Months Ended March 31, 2024 2023 (in thousands) Loss before income taxes: Operating loss Laboratory services $ ( 16,754 ) $ ( 21,603 ) Therapeutic development ( 5,044 ) ( 3,221 ) Total operating loss ( 21,798 ) ( 24,824 ) Interest and other income, net 7,625 3,775 Loss before income taxes $ ( 14,173 ) $ ( 21,049 ) Three Months Ended March 31, 2024 2023 (in thousands) Depreciation and amortization: Laboratory services $ 6,489 $ 6,720 Therapeutic development 174 159 Total $ 6,663 $ 6,879 March 31, December 31, 2024 2023 (in thousands) Assets: Laboratory services $ 1,140,688 $ 1,146,192 Therapeutic development 89,197 89,136 Total $ 1,229,885 $ 1,235,328
Summary of Revenue by Geographic Region	Geographic distribution of revenue: Three Months Ended March 31, 2024 2023 (in thousands) Revenue: United States $ 57,850 $ 62,062 Foreign China 4,104 2,088 Other countries 2,531 2,018 Total $ 64,485 $ 66,168
Summary of Property, Plant and Equipment, Net by Geographic Distribution	Geographic distribution of property, plant and equipment, net: March 31, December 31, 2024 2023 (in thousands) Fixed assets: Unites States $ 82,168 $ 77,938 Foreign 4,555 5,526 Total $ 86,723 $ 83,464

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2024
Leases [Abstract]
Schedule of Operating and Finance Lease Right-of-Use Asset, Short-term Lease Liabilities, and Long-term Lease Liabilities	The operating and finance lease right-of-use asset, short-term lease liabilities, and long-term lease liabilities as of March 31, 2024, and December 31, 2023, were as follows: March 31, December 31, 2024 2023 (in thousands) Operating lease ROU asset, net $ 9,225 $ 10,838 Operating lease liabilities, short term $ 2,910 $ 3,957 Operating lease liabilities, long term $ 6,579 $ 7,147 Finance lease ROU asset, net $ 1,175 $ 1,316 Finance lease liabilities, short term $ 543 $ 544 Finance lease liabilities, long term $ 622 $ 760
Schedule of Operating and Finance Lease Expenses	The following were operating and finance lease expenses: Three Months Ended March 31, 2024 2023 (in thousands) Operating lease cost $ 1,629 $ 1,702 Finance lease cost: Amortization of ROU assets 137 243 Interest on lease liabilities 12 27 Short-term lease cost 316 501 Total lease cost $ 2,094 $ 2,473
Schedule of Supplemental Information Related to Operating and Finance Leases	Supplemental information related to operating and finance leases were the following: March 31, 2024 Weighted average remaining lease term - operating leases 4.57 years Weighted average discount rate - operating leases 3.98 % Weighted average remaining lease term - finance lease 2.48 years Weighted average discount rate - finance lease 3.68 %
Schedule of Maturity Analysis of Operating and Finance Lease Liabilities using Undiscounted Cash Flows on an Annual Basis	The following is a maturity analysis of operating and finance lease liabilities using undiscounted cash flows on an annual basis with renewal periods included: Operating Leases Finance Lease (in thousands) Year Ending December 31, 2024 (remaining 9 months) $ 2,626 $ 383 2025 2,351 468 2026 1,777 366 2027 1,687 — 2028 544 — 2029 347 — Thereafter 1,178 — Total lease payments 10,510 1,217 Less imputed interest ( 1,021 ) ( 52 ) Total $ 9,489 $ 1,165
Schedule of Lease Income	Total lease income was as follows: Three Months Ended March 31, 2024 2023 (in thousands) Lease income $ 17 $ 45 Total lease income $ 17 $ 45
Schedule of Future Fixed Lease Payments from Tenants for All Noncancelable Operating Leases	Future fixed lease payments from tenants for all noncancelable operating leases as of March 31, 2024 are as follows: Lease Payments from Tenants (in thousands) Year Ending December 31, 2024 (remaining 9 months) $ 68 Total $ 68

Equity-Based Compensation (Tabl

Equity-Based Compensation (Tables)	3 Months Ended
	Mar. 31, 2024
Share-Based Payment Arrangement [Abstract]
Summary of Equity-Based Compensation	The Company has included equity-based compensation expense as part of cost of revenue and operating expenses in the accompanying Condensed Consolidated Statements of Operations as follows: Three Months Ended March 31, 2024 2023 (in thousands) Cost of revenue $ 2,009 $ 2,394 Research and development 3,844 3,448 Selling and marketing 1,050 1,361 General and administrative 4,615 3,062 Total $ 11,518 $ 10,265

Loss per Share (Tables)

Loss per Share (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Reconciliation of the Basic and Diluted Loss Per Share Computations	The following table presents the calculation of basic and diluted loss per share for the three months ended March 31, 2024 and 2023: Three Months Ended March 31, 2024 2023 (in thousands, except per share data) Net loss attributable to common shareholders $ ( 13,462 ) $ ( 15,340 ) Weighted-average common shares - outstanding, basic 29,769 29,536 Weighted-average common shares - outstanding, diluted 29,769 29,536 Loss per share: Basic $ ( 0.45 ) $ ( 0.52 ) Diluted $ ( 0.45 ) $ ( 0.52 )
Anti-dilutive Securities Excluded from Calculation of Diluted Loss Per Share	The following securities have been excluded from the calculation of diluted loss per share because their effect would have been anti-dilutive: Three Months Ended March 31, 2024 2023 (in thousands) Options 222 211 Restricted Stock Units 2,199 2,040 Contingently Issuable Shares 186 371

Goodwill and Acquisition-Rela_2

Goodwill and Acquisition-Related Intangibles (Tables)	3 Months Ended
	Mar. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Carrying Amount of Goodwill	Goodwill, net, as of March 31, 2024 and December 31, 2023 by reporting unit was as follows: March 31, December 31, 2024 2023 (in thousands) Goodwill: Laboratory services $ — $ — Therapeutic development 22,055 22,055 Total $ 22,055 $ 22,055
Summaries of Goodwill and Acquisitions-Related Intangibles Balances	Summaries of intangible asset balances as of March 31, 2024 and December 31, 2023 were as follows: March 31, December 31, Weighted-Average Amortization Period 2024 2023 (in thousands) Laboratory Services: Royalty-free technology 10 Years $ 5,124 $ 5,211 Less: accumulated amortization ( 1,495 ) ( 1,390 ) Royalty-free technology, net 3,629 3,821 Customer Relationships 13 Years 83,101 83,119 Less: accumulated amortization ( 14,204 ) ( 12,586 ) Customer relationships, net 68,897 70,533 Trade name 8 Years 3,790 3,790 Less: accumulated amortization ( 1,030 ) ( 906 ) Trade name, net 2,760 2,884 In-place lease intangible assets 5 Years 360 360 Less: accumulated amortization ( 134 ) ( 116 ) In-place lease intangible assets, net 226 244 Laboratory information system platform 5 Years 1,860 1,860 Less: accumulated amortization ( 992 ) ( 899 ) Laboratory information system platform, net 868 961 Purchased patent 10 Years 28 28 Less: accumulated amortization ( 9 ) ( 8 ) Purchased patent, net 19 20 Total 76,399 78,463 Therapeutic Development: In-process research & development n/a 64,590 64,590 Total 64,590 64,590 Total intangible assets, net $ 140,989 $ 143,053
Summary of Annual Amortization Expense For Acquisition-Related Intangibles	Based on the carrying value of finite-lived intangible assets recorded as of March 31, 2024, and assuming no subsequent impairment of the underlying assets, the annual amortization expense for intangible assets is expected to be as follows: Amounts (in thousands) Year Ending December 31, 2024 (remaining 9 months) $ 5,973 2025 7,963 2026 7,661 2027 7,201 2028 7,166 2029 6,909 Thereafter 33,526 Total $ 76,399

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Roll-Forward for Allowance for Credit Losses (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Accounts Receivable Allowance For Credit Losses [Line Items]
Allowance for credit losses at beginning of year	$ 25,226
Current period provision	(2,497)	$ (113)
Write-downs	(1,336)
Recoveries of amounts previously charged off	4,438
Allowance for credit losses as of March 31, 2024	$ 25,831

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Details)	3 Months Ended		12 Months Ended
	Mar. 31, 2024 USD ($) Segment Customer	Mar. 31, 2023 USD ($) Customer	Dec. 31, 2023 USD ($) Segment
Summary Of Significant Accounting Policies [Line Items]
Number of reporting segments | Segment	2		1
Contract with customer liability, revenue recognized	$ 860,000	$ 1,300,000
Redeemable preferred stock investment	20,438,000		$ 20,438,000
Unrealized gain (loss)	$ 0	597,000,000
Preferred stock, redemption date	Jul. 31, 2027
Tax effects related to net unrealized holding losses on available-for-sale debt securities		$ 1,900,000
Variable consideration	$ 1,200,000
Insurance Customer
Summary Of Significant Accounting Policies [Line Items]
Percentage of net accounts receivable from contract	43%		39%
Institutional Customer
Summary Of Significant Accounting Policies [Line Items]
Percentage of net accounts receivable from contract	57%		61%
Customer Concentration Risk | Revenue | Customer One
Summary Of Significant Accounting Policies [Line Items]
Number of customers | Customer	1	0
Revenues	$ 12,600,000
Concentration risk, percentage	20%	10%
Customer Concentration Risk | Accounts Receivable | Customer One
Summary Of Significant Accounting Policies [Line Items]
Number of customers | Customer	1
Concentration risk, percentage	12%		13%
Minimum
Summary Of Significant Accounting Policies [Line Items]
Intangible asset, useful life	3 years
Maximum
Summary Of Significant Accounting Policies [Line Items]
Intangible asset, useful life	14 years

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Summary of Revenue from Contracts with Customers by Payor Type (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Disaggregation Of Revenue [Line Items]
Revenue from contracts with customers by payor type	$ 64,485	$ 66,168
Accounting Standards Update 2014-09
Disaggregation Of Revenue [Line Items]
Revenue from contracts with customers by payor type	64,485	66,168
Accounting Standards Update 2014-09 | Clinical Insurance Contracts
Disaggregation Of Revenue [Line Items]
Revenue from contracts with customers by payor type	30,043	34,551
Accounting Standards Update 2014-09 | Clinical Institutional Contracts
Disaggregation Of Revenue [Line Items]
Revenue from contracts with customers by payor type	33,604	30,992
Accounting Standards Update 2014-09 | Clinical Patient Contracts
Disaggregation Of Revenue [Line Items]
Revenue from contracts with customers by payor type	$ 838	$ 625

Equity and Debt Securities - Su

Equity and Debt Securities - Summary of Equity and Debt Securities (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Less: Cash equivalents, Carrying Value	$ (21,718)	$ (38,291)
Less: Cash equivalents, Fair Value	(21,718)	(38,291)
Equity and debt securities, Amortized Cost Basis	833,058	789,726
Equity and debt securities, Unrealized Gains	729	1,909
Equity and debt securities, Unrealized Losses	(6,836)	(5,945)
Equity and debt securities, Aggregate Fair Value	826,951	785,690
Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	818,058	774,726
Debt securities, Unrealized Gains	729	1,909
Debt securities, Unrealized Losses	(6,836)	(5,945)
Debt securities, Aggregate Fair Value	811,951	770,690
Short-Term Marketable Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	253,479	330,630
Debt securities, Unrealized Gains	0	45
Debt securities, Unrealized Losses	(2,461)	(3,994)
Debt securities, Aggregate Fair Value	251,018	326,681
Short-Term Marketable Securities | U.S. Government Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	106,187	119,739
Debt securities, Unrealized Gains		8
Debt securities, Unrealized Losses	(1,059)	(1,765)
Debt securities, Aggregate Fair Value	105,128	117,982
Short-Term Marketable Securities | U.S. Agency Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	57,328	72,310
Debt securities, Unrealized Losses	(1,071)	(1,414)
Debt securities, Aggregate Fair Value	56,257	70,896
Short-Term Marketable Securities | U.S. Treasury Bills
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	45,613	69,214
Debt securities, Unrealized Gains		36
Debt securities, Unrealized Losses	(4)
Debt securities, Aggregate Fair Value	45,609	69,250
Short-Term Marketable Securities | Corporate Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	39,655	63,810
Debt securities, Unrealized Losses	(299)	(792)
Debt securities, Aggregate Fair Value	39,356	63,018
Short-Term Marketable Securities | Money Market Accounts
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	21,718	38,291
Debt securities, Aggregate Fair Value	21,718	38,291
Short-Term Marketable Securities | Municipal Bonds
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	4,696	5,557
Debt securities, Unrealized Gains		1
Debt securities, Unrealized Losses	(28)	(23)
Debt securities, Aggregate Fair Value	4,668	5,535
Long Term Equity Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Marketable and non-marketable securities, Amortized Cost Basis	15,000	15,000
Marketable and non-marketable securities, Aggregate Fair Value	15,000	15,000
Long Term Equity Securities | Preferred Stock Of Privately Held Company
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Marketable and non-marketable securities, Amortized Cost Basis	15,000	15,000
Marketable and non-marketable securities, Aggregate Fair Value	15,000	15,000
Debt Securities due After 1 Year through 5 Years
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	563,715	443,228
Debt securities, Unrealized Gains	728	1,863
Debt securities, Unrealized Losses	(4,368)	(1,941)
Debt securities, Aggregate Fair Value	560,075	443,150
Debt Securities due After 1 Year through 5 Years | U.S. Government Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	345,156	247,104
Debt securities, Unrealized Gains	284	1,262
Debt securities, Unrealized Losses	(2,102)	(578)
Debt securities, Aggregate Fair Value	343,338	247,788
Debt Securities due After 1 Year through 5 Years | U.S. Agency Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	151,721	156,150
Debt securities, Unrealized Gains	5	161
Debt securities, Unrealized Losses	(1,412)	(490)
Debt securities, Aggregate Fair Value	150,314	155,821
Debt Securities due After 1 Year through 5 Years | Corporate Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	41,025	12,885
Debt securities, Unrealized Losses	(760)	(765)
Debt securities, Aggregate Fair Value	40,265	12,120
Debt Securities due After 1 Year through 5 Years | Redeemable Preferred Stock Investment
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	20,000	20,000
Debt securities, Unrealized Gains	438	438
Debt securities, Aggregate Fair Value	20,438	20,438
Debt Securities due After 1 Year through 5 Years | Municipal Bonds
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	5,061	6,337
Debt securities, Unrealized Gains	1	2
Debt securities, Unrealized Losses	(35)	(48)
Debt securities, Aggregate Fair Value	5,027	6,291
Debt Securities due After 1 Year through 5 Years | Yankee Debt Securities
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	752	752
Debt securities, Unrealized Losses	(59)	(60)
Debt securities, Aggregate Fair Value	693	692
Debt Securities due After 5 Year through 10 Years
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	864	868
Debt securities, Unrealized Gains	1	1
Debt securities, Unrealized Losses	(7)	(10)
Debt securities, Aggregate Fair Value	858	859
Debt Securities due After 5 Year through 10 Years | Municipal Bonds
Schedule Of Trading Securities And Other Trading Assets [Line Items]
Debt securities, Amortized Cost Basis	864	868
Debt securities, Unrealized Gains	1	1
Debt securities, Unrealized Losses	(7)	(10)
Debt securities, Aggregate Fair Value	$ 858	$ 859

Equity and Debt Securities - Ad

Equity and Debt Securities - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Schedule Of Available For Sale And Trading Securities [Line Items]
Gross unrealized loss	$ 6.8	$ 5.9

Fair Value Measurements - Infor

Fair Value Measurements - Information about Financial Assets Measured at Fair Value on Recurring Basis Based on Three-Tier Fair Value Hierarchy (Details) - Fair Value Measurements Recurring - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total equity securities, debt securities and cash equivalents	$ 848,669	$ 823,981
U.S. Government Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	448,466	365,770
U.S. Agency Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	206,571	226,717
Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	79,621	75,138
U.S. Treasury Bills
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	45,609	69,250
Money Market Accounts
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash and cash equivalents fair value disclosure	21,718	38,291
Redeemable Preferred Stock Investment
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	20,438	20,438
Preferred Stock Of Privately Held Company
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	15,000	15,000
Municipal Bonds
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	10,553	12,685
Yankee Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	693	692
Level 1
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total equity securities, debt securities and cash equivalents	67,327	107,541
Level 1 | U.S. Treasury Bills
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	45,609	69,250
Level 1 | Money Market Accounts
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Cash and cash equivalents fair value disclosure	21,718	38,291
Level 2
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total equity securities, debt securities and cash equivalents	745,904	681,002
Level 2 | U.S. Government Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	448,466	365,770
Level 2 | U.S. Agency Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	206,571	226,717
Level 2 | Corporate Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	79,621	75,138
Level 2 | Municipal Bonds
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	10,553	12,685
Level 2 | Yankee Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	693	692
Level 3
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total equity securities, debt securities and cash equivalents	35,438	35,438
Level 3 | Redeemable Preferred Stock Investment
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	20,438	20,438
Level 3 | Preferred Stock Of Privately Held Company
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Total debt securities	$ 15,000	$ 15,000

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Details) - USD ($)	Mar. 31, 2024	Mar. 31, 2023
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fair value assets, transfers between levels, amount	$ 0	$ 0

Fixed Assets - Major Classes of

Fixed Assets - Major Classes of Fixed Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 133,509	$ 135,097
Less: Accumulated depreciation	(46,786)	(51,633)
Fixed assets, net	86,723	83,464
Medical Lab Equipment
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 48,493	56,025
Medical Lab Equipment | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	5 months
Medical Lab Equipment | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	12 years
Leasehold Improvements
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 10,090	11,222
Useful life in years	us-gaap:UsefulLifeShorterOfTermOfLeaseOrAssetUtilityMember
Building
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 9,781	9,781
Useful life in years	39 years
Computer Software
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 8,017	7,982
Computer Software | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	1 year
Computer Software | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	5 years
Building Improvements
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 7,741	7,748
Building Improvements | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	6 months
Building Improvements | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	39 years
Computer Hardware
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 6,780	6,805
Computer Hardware | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	1 year
Computer Hardware | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	5 years
Aircraft
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 6,400	6,400
Useful life in years	7 years
Furniture and Fixtures
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 3,615	3,860
Furniture and Fixtures | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	1 year
Furniture and Fixtures | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	5 years
Land Improvements
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 904	904
Land Improvements | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	5 years
Land Improvements | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	15 years
Automobile
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 445	445
Automobile | Minimum
Property Plant And Equipment [Line Items]
Useful life in years	3 years
Automobile | Maximum
Property Plant And Equipment [Line Items]
Useful life in years	7 years
General Equipment
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 109	115
Useful life in years	5 years
Land
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 8,800	8,800
Assets Not Yet Placed in Service
Property Plant And Equipment [Line Items]
Fixed assets, gross	$ 22,334	$ 15,010

Fixed Assets - Additional Infor

Fixed Assets - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Property, Plant and Equipment [Abstract]
Depreciation expense on fixed assets	$ 4.6	$ 4.7

Other Significant Balance She_3

Other Significant Balance Sheet Accounts - Schedule of Other Current Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Prepaid income taxes	$ 7,521	$ 12,675
Prepaid expenses	7,359	7,744
Reagents and supplies	6,528	5,827
Marketable securities interest receivable	6,281	4,994
Other receivable	1,065	1,319
Total	$ 28,754	$ 32,559

Other Significant Balance She_4

Other Significant Balance Sheet Accounts (Additional Information) (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Other Significant Balance Sheet Accounts [Line Items]
Accrued legal liabilities	$ 7,026	$ 7,026
Voluntary Disclosure Process
Other Significant Balance Sheet Accounts [Line Items]
Accrued legal liabilities	$ 6,900	$ 6,900

Other Significant Balance She_5

Other Significant Balance Sheet Accounts - Schedule of Accrued Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Accrued legal liabilities	$ 7,026	$ 7,026
Payroll liabilities	4,756	5,741
Accrued bonus and commission	4,067	6,255
Vacation accrual	3,765	3,543
Other accrued liabilities	3,394	4,215
Operating lease liabilities, short term	2,910	3,957
Total	$ 25,918	$ 30,737

Other Significant Balance She_6

Other Significant Balance Sheet Accounts - Schedule of Other Long-Term Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Operating lease liabilities, long term	$ 6,579	$ 7,147
Other long-term liabilities	4,835	4,973
Notes payable, long term	2,493	2,964
Total	$ 13,907	$ 15,084

Reportable Segment and Geogra_3

Reportable Segment and Geographic Information - Additional Information (Details) - Segment	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Segment Reporting [Abstract]
Number of reporting segments	2	1
Number of operating segments	2

Reportable Segment and Geogra_4

Reportable Segment and Geographic Information - Schedule of Information Regarding Operations and Assets for Operating Segments (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Segment Reporting Information [Line Items]
Revenue	$ 64,485	$ 66,168
Operating loss	(21,798)	(24,824)
Interest and other income, net	7,625	3,775
Loss before income taxes	(14,173)	(21,049)
Depreciation and amortization	6,663	6,879
Assets	1,229,885		$ 1,235,328
Laboratory Services
Segment Reporting Information [Line Items]
Revenue	64,485	66,168
Operating loss	(16,754)	(21,603)
Depreciation and amortization	6,489	6,720
Assets	1,140,688		1,146,192
Laboratory Services | Precision Diagnostics
Segment Reporting Information [Line Items]
Revenue	37,446	27,905
Laboratory Services | Anatomic Pathology
Segment Reporting Information [Line Items]
Revenue	23,107	26,411
Laboratory Services | BioPharma Services
Segment Reporting Information [Line Items]
Revenue	2,656	8,420
Laboratory Services | COVID-19
Segment Reporting Information [Line Items]
Revenue	1,276	3,432
Therapeutic Development
Segment Reporting Information [Line Items]
Revenue	0	0
Operating loss	(5,044)	(3,221)
Depreciation and amortization	174	$ 159
Assets	$ 89,197		$ 89,136

Reportable Segment and Geogra_5

Reportable Segment and Geographic Information - Summary of Revenue by Geographic Region (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Segment Reporting Information [Line Items]
Revenue	$ 64,485	$ 66,168
United States
Segment Reporting Information [Line Items]
Revenue	57,850	62,062
China
Segment Reporting Information [Line Items]
Revenue	4,104	2,088
Other countries
Segment Reporting Information [Line Items]
Revenue	$ 2,531	$ 2,018

Reportable Segment and Geogra_6

Reportable Segment and Geographic Information - Summary of Property, Plant and Equipment, Net by Geographic Distribution (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Segment Reporting Information [Line Items]
Fixed assets, net	$ 86,723	$ 83,464
United States
Segment Reporting Information [Line Items]
Fixed assets, net	82,168	77,938
Foreign
Segment Reporting Information [Line Items]
Fixed assets, net	$ 4,555	$ 5,526

Debt, Commitments and Conting_2

Debt, Commitments and Contingencies - Additional Information (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2023
Debt, Commitments and Contingencies [Line Items]
Notes payable, current portion	$ 413,000					$ 1,183,000
Notes payable, noncurrent portion	2,493,000					$ 2,964,000
Non-cancelable purchase obligations	57,900,000
Non-cancelable purchase obligations, payable within twelve months	39,600,000
Purchase obligations, payable within next five years	18,300,000
Estimated and recorded liability	6,900,000
HRSA Uninsured Program Member
Debt, Commitments and Contingencies [Line Items]
Contingencies reimbursements			$ 548,900,000	$ 548,900,000	$ 548,900,000
Xilong Scientific | FF Gene Biotech
Debt, Commitments and Contingencies [Line Items]
Interest expense	$ 8,000	$ 75,000
Debt instrument, interest rate terms	The Company also had notes payable to Xilong Scientific Co., which were paid off as of March 31, 2024, and had an interest rate of 4.97%.
Debt instrument, interest rate	4.97%
Installment Sale Contract
Debt, Commitments and Contingencies [Line Items]
Notes payable	$ 2,900,000
Notes payable, current portion	$ 413,000
Debt instrument, interest rate terms	The notes payable relate to the installment sale, are due in February 2030, and carry an interest rate of 1.08%
Debt instrument, interest rate	1.08%
Installment Sale Contract | Other Long-Term Liabilities
Debt, Commitments and Contingencies [Line Items]
Notes payable, noncurrent portion	$ 2,500,000

Leases - Additional Information

Leases - Additional Information (Details)	3 Months Ended
	Mar. 31, 2024
Lessee Lease Description [Line Items]
Operating leases term of expiration	2033-04
Finance leases term of expiration	2026-12
Building
Lessee Lease Description [Line Items]
Remaining term including renewal options	9 months

Leases - Schedule of Operating

Leases - Schedule of Operating and Finance Lease Right-of-Use Asset, Short-term Lease Liabilities, and Long-term Lease Liabilities (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Leases [Abstract]
Operating lease ROU asset, net	$ 9,225	$ 10,838
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other long-term assets	Other long-term assets
Operating lease liabilities, short term	$ 2,910	$ 3,957
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities	Accrued liabilities
Operating lease liabilities, long term	$ 6,579	$ 7,147
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities
Finance lease ROU asset, net	$ 1,175	$ 1,316
Finance Lease, Right-of-Use Asset, Statement of Financial Position [Extensible Enumeration]	Other long-term assets	Other long-term assets
Finance lease liabilities, short term	$ 543	$ 544
Finance Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Accrued liabilities	Accrued liabilities
Finance lease liabilities, long term	$ 622	$ 760
Finance Lease, Liability, Noncurrent, Statement of Financial Position [Extensible Enumeration]	Other long-term liabilities	Other long-term liabilities

Leases - Schedule of Operatin_2

Leases - Schedule of Operating and Financing Lease Expenses (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Leases [Abstract]
Operating lease cost	$ 1,629	$ 1,702
Finance lease cost:
Amortization of ROU assets	137	243
Interest on lease liabilities	12	27
Short-term lease cost	316	501
Total lease cost	$ 2,094	$ 2,473

Leases - Schedule of Supplement

Leases - Schedule of Supplemental Information Related to Operating and Finance Leases (Details)	Mar. 31, 2024
Leases [Abstract]
Weighted average remaining lease term - operating leases	4 years 6 months 25 days
Weighted average discount rate - operating leases	3.98%
Weighted average remaining lease term - finance lease	2 years 5 months 23 days
Weighted average discount rate - finance lease	3.68%

Leases - Schedule of Maturity A

Leases - Schedule of Maturity Analysis of Operating and Finance Lease Liabilities using Undiscounted Cash Flows on an Annual Basis (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Operating Leases
2024 (remaining 9 months)	$ 2,626
2025	2,351
2026	1,777
2027	1,687
2028	544
2029	347
Thereafter	1,178
Total lease payments	10,510
Less imputed interest	(1,021)
Total	9,489
Finance Lease
2024 (remaining 9 months)	383
2025	468
2026	366
Total lease payments	1,217
Less imputed interest	(52)
Total	$ 1,165

Leases - Schedule of Lease Inco

Leases - Schedule of Lease Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Leases [Abstract]
Lease income	$ 17	$ 45
Total lease income	$ 17	$ 45
Operating Lease, Lease Income, Statement of Income or Comprehensive Income [Extensible Enumeration]	Interest and Other Income	Interest and Other Income

Leases - Schedule of Future Fix

Leases - Schedule of Future Fixed Lease Payments from Tenants for All Noncancelable Operating Leases (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Leases [Abstract]
2024 (remaining 9 months)	$ 68
Total	$ 68

Equity-Based Compensation - Sum

Equity-Based Compensation - Summary of Equity-Based Compensation Expenses as Part of Cost of Revenue and Operating Expenses (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Equity-based compensation expense	$ 11,518	$ 10,265
Cost of Revenue
Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Equity-based compensation expense	2,009	2,394
Research and Development
Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Equity-based compensation expense	3,844	3,448
Selling and Marketing
Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Equity-based compensation expense	1,050	1,361
General and Administrative
Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Total Equity-based compensation expense	$ 4,615	$ 3,062

Income Taxes - Additional Infor

Income Taxes - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Tax Disclosure [Abstract]
Benefit from income taxes	$ 327,000	$ 5,200,000
Effective income tax rate	2%	25%
Income tax refund	$ 6,200,000	$ 657,000

Loss per Share - Reconciliation

Loss per Share - Reconciliation of Basic and Diluted Income (Loss) Per Share Computations (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Earnings Per Share Basic And Diluted [Line Items]
Net loss attributable to common shareholders	$ (13,462)	$ (15,340)
Weighted-average common shares—outstanding, basic	29,769	29,536
Weighted-average effect of dilutive securities:
Weighted-average common shares—outstanding, diluted	29,769	29,536
Loss per share, basic	$ (0.45)	$ (0.52)
Loss per share, diluted	$ (0.45)	$ (0.52)

Loss per Share - Anti-dilutive

Loss per Share - Anti-dilutive Securities Excluded from Calculation of Diluted Loss Per Share (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Employee Stock Option
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted income per share	222	211
Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted income per share	2,199	2,040
Contingently Issuable Shares
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Anti-dilutive securities excluded from calculation of diluted income per share	186	371

Related Parties - Additional In

Related Parties - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Related Party Transaction [Line Items]
Due to related parties	$ 0		$ 164,000
ANP Technologies, Inc., | Ming Hsieh
Related Party Transaction [Line Items]
Ownership percentage	20%
AHMC Healthcare Inc. | Genetic Sequencing Services
Related Party Transaction [Line Items]
Revenue from related parties		$ 95,000
Revenue, Related Party, Type [Extensible Enumeration]	us-gaap:RelatedPartyMember	us-gaap:RelatedPartyMember
Trade accounts receivable, net from related parties	$ 11,000		$ 13,000
Accounts Receivable, after Allowance for Credit Loss, Related Party, Type [Extensible Enumeration]	us-gaap:RelatedPartyMember		us-gaap:RelatedPartyMember
ANP Technologies Inc
Related Party Transaction [Line Items]
Due to related parties	$ 193,000		$ 0
Other Liability, Current, Related Party, Type [Extensible Enumeration]	us-gaap:RelatedPartyMember		us-gaap:RelatedPartyMember
Purchase of COVID-19 antigen rapid tests kits from related party	$ 651,000	$ 959,000
ANP Technologies Inc | Employee Service Agreements
Related Party Transaction [Line Items]
Due to related parties	$ 56,000		$ 29,000
Other Liability, Current, Related Party, Type [Extensible Enumeration]	us-gaap:RelatedPartyMember		us-gaap:RelatedPartyMember
Service of related party	$ 77,000	$ 0

Goodwill and Acquisition-Rela_3

Goodwill and Acquisition-Related Intangibles - Summary of Carrying Amount of Goodwill (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Goodwill [Line Items]
Goodwill, net	$ 22,055	$ 22,055
Therapeutic Development
Goodwill [Line Items]
Goodwill, net	$ 22,055	$ 22,055

Goodwill and Acquisition-Rela_4

Goodwill and Acquisition-Related Intangibles - Additional Information (Details) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2024 USD ($) Segment	Mar. 31, 2023 USD ($)	Dec. 31, 2023 Segment
Goodwill and Intangible Assets Disclosure [Abstract]
Number of operating segments	2
Number of reporting segments	2		1
Amortization of intangible assets | $	$ 1,990	$ 1,968

Goodwill and Acquisition-Rela_5

Goodwill and Acquisition-Related Intangibles - Summaries of Goodwill and Acquisitions-Related Intangibles Balances (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, net	$ 76,399
Total intangible assets, net	140,989	$ 143,053
Laboratory Services
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, net	76,399	78,463
Laboratory Services | Royalty-Free Technology
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	5,124	5,211
Less: accumulated amortization	(1,495)	(1,390)
Acquisitions-related intangibles, net	$ 3,629	3,821
Weighted-Average Amortization Period	10 years
Laboratory Services | Customer Relationships
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 83,101	83,119
Less: accumulated amortization	(14,204)	(12,586)
Acquisitions-related intangibles, net	$ 68,897	70,533
Weighted-Average Amortization Period	13 years
Laboratory Services | Trade Name
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 3,790	3,790
Less: accumulated amortization	(1,030)	(906)
Acquisitions-related intangibles, net	$ 2,760	2,884
Weighted-Average Amortization Period	8 years
Laboratory Services | In-Place Lease Intangible Assets
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 360	360
Less: accumulated amortization	(134)	(116)
Acquisitions-related intangibles, net	$ 226	244
Weighted-Average Amortization Period	5 years
Laboratory Services | Laboratory Information System Platform
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 1,860	1,860
Less: accumulated amortization	(992)	(899)
Acquisitions-related intangibles, net	$ 868	961
Weighted-Average Amortization Period	5 years
Laboratory Services | Purchased Patent
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 28	28
Less: accumulated amortization	(9)	(8)
Acquisitions-related intangibles, net	$ 19	20
Weighted-Average Amortization Period	10 years
Therapeutic Development
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 64,590	64,590
Therapeutic Development | In-Process Research & Development
Goodwill And Intangible Assets [Line Items]
Acquisitions-related intangibles, gross	$ 64,590	$ 64,590

Goodwill and Acquisition-Rela_6

Goodwill and Acquisition-Related Intangibles - Summary of Annual Amortization Expense For Acquisition-Related Intangibles (Details) $ in Thousands	Mar. 31, 2024 USD ($)
Finite Lived Intangible Assets [Line Items]
2024 (remaining 9 months)	$ 5,973
2025	7,963
2026	7,661
2027	7,201
2028	7,166
2029	6,909
Thereafter	33,526
Acquisitions-related intangibles, net	$ 76,399

Business Combinations - Additio

Business Combinations - Additional Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill	$ 22,055		$ 22,055
Revenue	64,485	$ 66,168
Operating income (loss)	$ (21,798)	$ (24,824)

Business Combinations - Summary

Business Combinations - Summary of Consideration Paid and Amount of Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill	$ 22,055	$ 22,055

Stock Repurchase Program - Addi

Stock Repurchase Program - Additional Information (Details) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Mar. 31, 2022
Stockholders' Equity Note [Abstract]
Stock repurchase program, authorized amount			$ 250,000,000
Number of shares repurchased	10,000	0
Aggregate cost of shares repurchased	$ 225,000
Stock repurchase program, remaining authorized amount	$ 150,500,000

Retirement Plans - Additional I

Retirement Plans - Additional Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Defined Contribution Plan Disclosure [Line Items]
Company matching contributions to the 401(k) plan	$ 1	$ 1

Subsequent Events - Additional

Subsequent Events - Additional Information (Details)	3 Months Ended
	Mar. 31, 2024 USD ($)
Subsequent Event [Line Items]
Aggregate cost of shares repurchased	$ 225,000