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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
CASH FLOWS FROM OPERATING ACTIVITIES      
Net loss $ (87,968,000) $ (144,250,000) $ (8,347,000)
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation 37,450,000 35,372,000 30,192,000
Amortization of intangibles 35,133,000 34,058,000 23,160,000
Non-cash stock-based compensation 24,633,000 24,672,000 22,458,000
Non-cash operating lease expense 9,235,000 9,775,000 8,716,000
Amortization of convertible debt discount 2,691,000 2,657,000 2,563,000
Amortization of debt issuance costs 185,000 182,000 178,000
Gain on investment in and loan receivable from non-consolidated affiliate, net 0 0 (109,260,000)
Interest on loan receivable from non-consolidated affiliate 0 0 (391,000)
Loss on disposal of assets 292,000 2,858,000 606,000
Gain on sale of assets held for sale 0 (2,048,000) 0
Impairment of long-lived assets 1,703,000 718,000 0
Write off of COVID-19 PCR testing inventory and equipment 0 0 6,061,000
Other non-cash items 186,000 1,714,000 1,941,000
Changes in assets and liabilities, net:      
Accounts receivable, net (11,516,000) (7,581,000) (4,691,000)
Inventories (454,000) (1,100,000) 1,634,000
Prepaid lease asset 0 0 (4,788,000)
Prepaid and other assets (3,180,000) (1,160,000) (1,906,000)
Operating lease liabilities (7,623,000) (8,557,000) (7,875,000)
Deferred income tax liabilities, net (11,193,000) (16,098,000) (6,299,000)
Accrued compensation 13,020,000 1,837,000 11,614,000
Accounts payable, accrued and other liabilities (4,547,000) 958,000 7,711,000
Net cash used in operating activities (1,953,000) (65,993,000) (26,723,000)
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchases of marketable securities (6,756,000) (97,605,000) (196,791,000)
Proceeds from maturities of marketable securities 112,215,000 116,915,000 62,970,000
Purchases of property and equipment (28,752,000) (30,891,000) (64,142,000)
Proceeds from assets held for sale 0 12,098,000 0
Business acquisitions, net of cash acquired 0 0 (419,404,000)
Loan receivable from non-consolidated affiliate 0 0 (15,000,000)
Net cash provided by (used in) investing activities 76,707,000 517,000 (632,367,000)
CASH FLOWS FROM FINANCING ACTIVITIES      
Repayment of equipment financing obligations (70,000) (758,000) (3,047,000)
Issuance of common stock, net 4,624,000 12,587,000 15,080,000
Proceeds from issuance of convertible debt, net of issuance costs 0 0 334,410,000
Premiums paid for capped call transactions 0 0 (29,291,000)
Proceeds from equity offering, net of issuance costs 0 0 408,133,000
Net cash provided by financing activities 4,554,000 11,829,000 725,285,000
Net change in cash and cash equivalents 79,308,000 (53,647,000) 66,195,000
Cash, cash equivalents and restricted cash, beginning of year 263,180,000 316,827,000 250,632,000
Cash, cash equivalents and restricted cash, end of year 342,488,000 263,180,000 316,827,000
Supplemental disclosure of cash flow information:      
Interest paid 3,380,000 3,404,000 3,065,000
Income taxes paid, net 175,000 180,000 148,000
Supplemental disclosure of non-cash investing and financing information:      
Fair value of common stock issued to fund business acquisition 0 0 29,174,000
Purchases of property and equipment included in accounts payable $ 610,000 $ 1,688,000 $ 1,315,000

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