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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
CASH FLOWS FROM OPERATING ACTIVITIES      
NET (LOSS) INCOME $ (144,250,000) $ (8,347,000) $ 4,172,000
Adjustments to reconcile net (loss) income to net cash provided by operating activities:      
Depreciation 35,372,000 30,192,000 25,904,000
Amortization of intangibles 34,058,000 23,160,000 9,817,000
Non-cash stock-based compensation 24,672,000 22,458,000 10,212,000
Non-cash operating lease expense 9,775,000 8,716,000 6,168,000
Amortization of convertible debt discount 2,657,000 2,563,000 4,358,000
Amortization of debt issuance costs 182,000 178,000 165,000
Loss on debt extinguishment 0 0 1,400,000
Loss on termination of cash flow hedge 0 0 3,506,000
Gain on investment in and loan receivable from non-consolidated affiliate, net 0 (109,260,000) (3,955,000)
Interest on loan receivable from non-consolidated affiliate 0 (391,000) 0
Loss on disposal of assets 2,858,000 606,000 450,000
Gain on sale of assets held for sale (2,048,000) 0 0
Impairment of long-lived assets 718,000 0 0
Write off of COVID-19 PCR testing inventory and equipment 0 6,061,000 0
Other non-cash items 1,714,000 1,941,000 1,010,000
Changes in assets and liabilities, net:      
Accounts receivable, net (7,581,000) (4,691,000) (12,601,000)
Inventories (1,100,000) 1,634,000 (15,197,000)
Prepaid lease asset 0 (4,788,000) (20,229,000)
Prepaid and other assets (1,160,000) (1,906,000) (9,750,000)
Operating lease liabilities (8,557,000) (7,875,000) (4,916,000)
Deferred income tax liabilities, net (16,098,000) (6,299,000) (10,972,000)
Accounts payable, accrued and other liabilities 2,795,000 19,325,000 11,918,000
Net cash (used in) provided by operating activities (65,993,000) (26,723,000) 1,460,000
CASH FLOWS FROM INVESTING ACTIVITIES      
Purchases of marketable securities (97,605,000) (196,791,000) (73,101,000)
Proceeds from sales and maturities of marketable securities 116,915,000 62,970,000 5,356,000
Purchases of property and equipment (30,891,000) (64,142,000) (29,096,000)
Proceeds from assets held for sale 12,098,000 0 0
Business acquisitions, net of cash acquired 0 (419,404,000) (37,000,000)
Investment in non-consolidated affiliate 0 0 (25,600,000)
Loan receivable from non-consolidated affiliate 0 (15,000,000) 0
Net cash provided by (used in) investing activities 517,000 (632,367,000) (159,441,000)
CASH FLOWS FROM FINANCING ACTIVITIES      
Repayment of equipment financing obligations (758,000) (3,047,000) (5,615,000)
Repayment of term loan 0 0 (97,540,000)
Cash flow hedge termination 0 0 (3,317,000)
Issuance of common stock, net 12,587,000 15,080,000 20,310,000
Proceeds from issuance of convertible debt, net of issuance costs 0 334,410,000 194,466,000
Premiums paid for capped call transactions 0 (29,291,000) 0
Proceeds from equity offering, net of issuance costs 0 408,133,000 127,293,000
Net cash provided by financing activities 11,829,000 725,285,000 235,597,000
Net change in cash and cash equivalents (53,647,000) 66,195,000 77,616,000
Cash, cash equivalents and restricted stock, beginning of year 316,827,000 250,632,000 173,016,000
Cash, cash equivalents and restricted cash, end of year 263,180,000 316,827,000 250,632,000
Cash and cash equivalents 263,180,000 316,827,000 228,713,000
Restricted cash 0 0 21,919,000
Supplemental disclosure of cash flow information:      
Interest paid 3,404,000 3,065,000 2,926,000
Income taxes paid, net 180,000 148,000 246,000
Supplemental disclosure of non-cash investing and financing information:      
Fair value of common stock issued to fund business acquisition 0 29,174,000 0
Equipment acquired under financing obligations 0 0 428,000
Purchases of property and equipment included in accounts payable $ 1,688,000 $ 1,315,000 $ 2,007,000

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