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Property and Equipment (Details) - USD ($)
$ in Thousands
Jun. 30, 2020
Dec. 31, 2019
Property, Plant and Equipment [Line Items]    
Total property and equipment, cost $ 802,648 $ 776,240
Accumulated depreciation (347,824) (320,155)
Net property and equipment 454,824 456,085 [1]
Machinery and Equipment, Gross 246,955 219,057
Furniture and Fixtures, Gross 7,495 7,498
Construction in Progress, Gross 76,733 101,425
Land, Buildings and Improvements [Member]    
Property, Plant and Equipment [Line Items]    
Total property and equipment, cost 233,931 230,454
Molds [Member]    
Property, Plant and Equipment [Line Items]    
Total property and equipment, cost 60,378 60,155
Computer Equipment and Software [Member]    
Property, Plant and Equipment [Line Items]    
Total property and equipment, cost 96,711 83,217
Instruments Placed with Customers [Member]    
Property, Plant and Equipment [Line Items]    
Total property and equipment, cost $ 80,445 $ 74,434
[1] December 31, 2019 balances were derived from audited consolidated financial statements.