Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net loss	$ (188,863)	$ (328,405)	$ (30,143)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	105,297	108,655	78,716
Non-cash interest	2,750	2,750	9,389
Amortization of debt discount and debt issuance costs	1,222	1,161	785
Losses from investments in investees	107	383	629
Equity-based compensation – employees and non-employees	11,413	18,509	13,632
Non-cash revenue from the transfer of intellectual property	0	0	(3,801)
Realized loss (gain) on disposal of fixed assets and sales of equity securities	1,321	(455)	(33,922)
Loss on conversion of the 2025 Notes	0	0	11,111
Change in fair value of equity securities and derivative instruments	17,647	153,835	3,967
Contingent consideration	(1,036)	(1,312)	(1,703)
Gain on sale of GeneDx	0	(18,559)	0
Deferred income tax provision	146	(74,405)	10,159
Changes in assets and liabilities, net of the effects of acquisitions:
Accounts receivable, net	3,411	128,602	5,232
Inventory, net	15,197	13,662	30,684
Other current assets and prepaid expenses	7,164	(3,416)	1,478
Other assets	(288)	1,935	260
Accounts payable	2,828	(9,388)	(10,847)
Foreign currency measurement	(1,036)	2,369	2,345
Contract liabilities	(131)	(329)	(15,911)
Accrued expenses and other liabilities	(5,346)	(90,781)	(33,723)
Net cash (used in) provided by operating activities	(28,197)	(95,189)	38,337
Cash flows from investing activities:
Investments in investees	(5,000)	0	(2,000)
Proceeds from sale of investments	364	115,423	8,079
Acquisition of businesses, net of cash acquired	0	(1,758)	(4,000)
Proceeds from the sale of property, plant and equipment	2,713	1,951	66,026
Capital expenditures	(16,275)	(24,578)	(32,156)
Net cash (used in) provided by investing activities	(18,198)	91,038	35,949
Cash flows from financing activities:
Debt issuance costs	0	0	(188)
Net activity from the exercise of common stock options and warrants	(272)	(774)	1,081
Borrowings on lines of credit	671,678	1,059,519	1,684,713
Repayments of lines of credit	(679,709)	(1,035,774)	(1,695,956)
Redemption of 2033 Senior Notes	(3,000)	0	0
Net cash (used in) provided by financing activities	(11,303)	22,971	(10,350)
Effect of exchange rate changes on cash and cash equivalents	388	(339)	(1,437)
Net increase (decrease) in cash and cash equivalents	(57,310)	18,481	62,499
Cash and cash equivalents at beginning of period	153,191	134,710	72,211
Cash and cash equivalents at end of period	95,881	153,191	134,710
SUPPLEMENTAL INFORMATION:
Interest paid	8,135	7,420	8,515
Income taxes paid, net of refunds	3,712	8,037	5,969
Operating lease right-of-use assets obtained in exchange for lease obligations	29,363	0	6,493
Assets acquired by finance leases	203	4,717	0
Non-cash financing:
2025 convertible Notes	0	0	68,775
Common Stock options and warrants, surrendered in net exercise	301	1,268	0
Issuance of common stock for acquisition of ModeX	0	221,662	0
Fair value of shares included in consideration from GeneDx Holdings	$ 6,689	$ 172,000	$ 0