CAREDX, INC., 10-K filed on 2/25/2026
Annual Report
v3.25.4
Cover Page - USD ($)
$ in Billions
 12 Months Ended
Dec. 31, 2025
Feb. 19, 2026
Jun. 30, 2025
Cover [Abstract]      
Document Type 10-K    
Document Annual Report true    
Document Period End Date Dec. 31, 2025    
Current Fiscal Year End Date --12-31    
Document Transition Report false    
Entity File Number 001-36536    
Entity Registrant Name CAREDX, INC.    
Entity Incorporation, State or Country Code DE    
Entity Tax Identification Number 94-3316839    
Entity Address, Address Line One 8000 Marina Boulevard    
Entity Address, City or Town Brisbane    
Entity Address, State or Province CA    
Entity Address, Postal Zip Code 94005    
City Area Code 415    
Local Phone Number 287-2300    
Title of 12(b) Security Common Stock, par value $0.001 per share    
Trading Symbol CDNA    
Security Exchange Name NASDAQ    
Entity Well-known Seasoned Issuer Yes    
Entity Voluntary Filers No    
Entity Current Reporting Status Yes    
Entity Interactive Data Current Yes    
Entity Small Business false    
Entity Emerging Growth Company false    
ICFR Auditor Attestation Flag true    
Entity Shell Company false    
Document Financial Statement Error Correction Flag false    
Entity Public Float     $ 1.0
Entity Common Stock, Shares Outstanding   51,216,344  
Documents Incorporated by Reference Portions of the registrant’s Proxy Statement relating to the 2026 Annual Meeting of Stockholders are incorporated by reference into Part III of this Annual Report on Form 10-K where indicated. Such Proxy Statement, or an amendment to this Annual Report on Form 10-K, will be filed with the Securities and Exchange Commission within 120 days after the end of the registrant’s fiscal year ended December 31, 2025.    
Amendment Flag false    
Document Fiscal Year Focus 2025    
Document Fiscal Period Focus FY    
Entity Central Index Key 0001217234    
Entity Filer Category Large Accelerated Filer    
v3.25.4
Audit Information
 12 Months Ended
Dec. 31, 2025
Audit Information [Abstract]  
Auditor Name Deloitte & Touche LLP
Auditor Location San Francisco, California
Auditor Firm ID 34
v3.25.4
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Current assets:    
Cash and cash equivalents $ 65,429 $ 114,689
Marketable securities 111,779 145,964
Accounts receivable 42,628 64,605
Inventory 26,705 19,503
Prepaid and other current assets 10,591 7,071
Total current assets 257,132 351,832
Property and equipment, net 32,971 33,552
Operating lease right-of-use assets 22,760 24,340
Marketable securities, non-current 24,165 0
Intangible assets, net 31,960 38,184
Goodwill 40,336 40,336
Restricted cash 551 585
Other assets 3,353 2,221
Total assets 413,228 491,050
Current liabilities:    
Accounts payable 9,988 7,686
Accrued compensation 38,107 38,333
Accrued and other liabilities 41,754 43,352
Total current liabilities 89,849 89,371
Deferred tax liability 181 164
Contingent consideration 161 174
Operating lease liabilities, less current portion 19,679 22,263
Other liabilities 257 645
Total liabilities 110,127 112,617
Commitments and contingencies (Note 8)
Stockholders’ equity:    
Preferred stock: $0.001 par value; 10,000,000 shares authorized at December 31, 2025 and 2024; no shares issued and outstanding at December 31, 2025 and 2024 0 0
Common stock: $0.001 par value; 100,000,000 shares authorized at December 31, 2025 and 2024; 50,916,644 shares issued and outstanding at December 31, 2025; 54,771,203 shares issued and outstanding at December 31, 2024 50 51
Additional paid-in capital 1,043,925 1,013,193
Accumulated other comprehensive loss (5,515) (8,569)
Accumulated deficit (735,359) (626,242)
Total stockholders’ equity 303,101 378,433
Total liabilities and stockholders’ equity $ 413,228 $ 491,050
Common stock, shares outstanding (in shares) 50,916,644 54,771,203
Common stock, shares issued (in shares) 50,916,644 54,771,203
v3.25.4
Consolidated Balance Sheets (Parenthetical) - $ / shares
Dec. 31, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Preferred stock, par value (in dollars per share) $ 0.001 $ 0.001
Preferred stock, shares authorized (in shares) 10,000,000 10,000,000
Preferred stock, shares issued (in shares) 0 0
Preferred stock, shares outstanding (in shares) 0 0
Common stock, par value (in dollars per share) $ 0.001 $ 0.001
Common stock, shares authorized (in shares) 100,000,000 100,000,000
Common stock, shares issued (in shares) 50,916,644 54,771,203
Common stock, shares outstanding (in shares) 50,916,644 54,771,203
v3.25.4
Consolidated Statements of Operations - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Revenues [Abstract]      
Total revenue $ 379,805 $ 333,785 $ 280,324
Operating expenses:      
Research and development 71,429 72,510 82,421
Sales and marketing 102,643 81,975 84,062
General and administrative 107,565 125,139 118,838
Litigation settlement expense 5,710 (96,300) 96,300
Total operating expenses 410,586 293,020 483,687
(Loss) income from operations (30,781) 40,765 (203,363)
Other income:      
Interest income, net 9,174 11,765 11,867
Other income, net 524 329 1,353
Total other income 9,698 12,094 13,220
(Loss) income before income taxes (21,083) 52,859 (190,143)
Income tax expense (271) (310) (141)
Net (loss) income $ (21,354) $ 52,549 $ (190,284)
Net (loss) income per share (Note 3):      
Basic (in dollars per share) $ (0.40) $ 1.00 $ (3.54)
Diluted (in dollars per share) $ (0.40) $ 0.93 $ (3.54)
Weighted-average shares used to compute net (loss) income per share:      
Basic (in shares) 53,287,546 52,773,247 53,764,705
Diluted (in shares) 53,287,546 56,620,590 53,764,705
Testing services revenue      
Revenues [Abstract]      
Total revenue $ 274,495 $ 249,381 $ 209,685
Operating expenses:      
Cost of testing services, product, patient and digital solutions 62,045 55,611 57,642
Product revenue      
Revenues [Abstract]      
Total revenue 48,377 40,783 33,517
Operating expenses:      
Cost of testing services, product, patient and digital solutions 22,953 23,381 18,379
Patient and digital solutions revenue      
Revenues [Abstract]      
Total revenue 56,933 43,621 37,122
Operating expenses:      
Cost of testing services, product, patient and digital solutions $ 38,241 $ 30,704 $ 26,045
v3.25.4
Consolidated Statements of Comprehensive Loss - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Statement of Comprehensive Income [Abstract]      
Net (loss) income $ (21,354) $ 52,549 $ (190,284)
Other comprehensive income (loss):      
Foreign currency translation adjustment, net of tax 3,054 (1,606) 540
Comprehensive (loss) income $ (18,300) $ 50,943 $ (189,744)
v3.25.4
Consolidated Statements of Stockholders’ Equity - USD ($)
$ in Thousands
Total
Common Stock
Additional Paid-In Capital
Accumulated Other Comprehensive Loss
Accumulated Deficit
Beginning balance (in shares) at Dec. 31, 2022   53,533,250      
Beginning balance at Dec. 31, 2022 $ 430,911 $ 52 $ 898,806 $ (7,503) $ (460,444)
Increase (Decrease) in Stockholders' Equity [Roll Forward]          
Issuance of common stock under employee stock purchase plan (in shares)   190,841      
Issuance of common stock under employee stock purchase plan 1,495   1,495    
Repurchase and retirement of common stock (in shares)   (2,942,997)      
Repurchase and retirement of common stock (27,544) $ (3)     (27,541)
RSU settlements, net of shares withheld (in shares)   669,283      
RSU settlements, net of shares withheld (3,059)   (3,059)    
Issuance of common stock for services (in shares)   21,965      
Issuance of common stock for services 216   216    
Issuance of common stock for cash upon exercise of stock options (in shares)   27,903      
Issuance of common stock for cash upon exercise of stock options 120   120    
Issuance of common stock for cash upon exercise of warrants (in shares)   3,132      
Issuance of common stock upon exercise of warrants 26   26    
Employee stock-based compensation expense 48,907   48,907    
Foreign currency translation adjustment 540     540  
Net (loss) income (190,284)       (190,284)
Ending balance (in shares) at Dec. 31, 2023   51,503,377      
Ending balance at Dec. 31, 2023 261,328 $ 49 946,511 (6,963) (678,269)
Increase (Decrease) in Stockholders' Equity [Roll Forward]          
Issuance of common stock under employee stock purchase plan (in shares)   159,019      
Issuance of common stock under employee stock purchase plan 1,397   1,397    
Repurchase and retirement of common stock (in shares)   (55,500)      
Repurchase and retirement of common stock (522)       (522)
RSU settlements, net of shares withheld (in shares)   2,620,716      
RSU settlements, net of shares withheld (10,090) $ 2 (10,092)    
Issuance of common stock for services (in shares)   16,582      
Issuance of common stock for services 174   174    
Issuance of common stock for cash upon exercise of stock options (in shares)   527,009      
Issuance of common stock for cash upon exercise of stock options 8,936   8,936    
Employee stock-based compensation expense 66,267   66,267    
Foreign currency translation adjustment (1,606)     (1,606)  
Net (loss) income $ 52,549       52,549
Ending balance (in shares) at Dec. 31, 2024 54,771,203 54,771,203      
Ending balance at Dec. 31, 2024 $ 378,433 $ 51 1,013,193 (8,569) (626,242)
Increase (Decrease) in Stockholders' Equity [Roll Forward]          
Issuance of common stock under employee stock purchase plan (in shares)   150,981      
Issuance of common stock under employee stock purchase plan 2,272 $ 1 2,271    
Repurchase and retirement of common stock (in shares)   (5,790,952)      
Repurchase and retirement of common stock (87,768) $ (5)     (87,763)
RSU settlements, net of shares withheld (in shares)   1,424,235      
RSU settlements, net of shares withheld (12,120) $ 1 (12,121)    
Issuance of common stock for services (in shares)   4,794      
Issuance of common stock for services $ 89 $ 1 88    
Issuance of common stock for cash upon exercise of stock options (in shares) 356,383 356,383      
Issuance of common stock for cash upon exercise of stock options $ 5,723 $ 1 5,722    
Employee stock-based compensation expense 34,772   34,772    
Foreign currency translation adjustment 3,054     3,054  
Net (loss) income $ (21,354)       (21,354)
Ending balance (in shares) at Dec. 31, 2025 50,916,644 50,916,644      
Ending balance at Dec. 31, 2025 $ 303,101 $ 50 $ 1,043,925 $ (5,515) $ (735,359)
v3.25.4
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Operating activities:      
Net (loss) income $ (21,354) $ 52,549 $ (190,284)
Adjustments to reconcile net (loss) income to net cash provided by (used in) operating activities:      
Stock-based compensation 34,864 66,406 49,086
Asset impairments and write-downs 0 0 1,000
Impairment of intangible asset and associated construction in progress 2,258 0 0
Depreciation and amortization 15,018 14,194 14,386
Amortization of right-of-use assets 5,398 5,563 5,438
Realized gain on sale of long-term marketable equity securities, net 0 0 (284)
Loss on disposal of asset 48 91 44
Gain on settlement of obligation and recovery of written-off investment 0 0 (2,109)
Revaluation of common stock warrant liability to estimated fair value 0 0 (10)
Revaluation of contingent consideration to estimated fair value 703 931 2,677
Amortization of premium and accretion of discount on marketable securities, net 1,273 621 (4,927)
Changes in operating assets and liabilities:      
Accounts receivable 22,521 (13,741) 16,016
Inventory (4,959) (1,018) 54
Prepaid and other assets (4,413) 606 1,767
Accounts payable 808 (5,110) 2,904
Accrued compensation (845) 18,667 2,655
Accrued and other liabilities (3,308) (95,661) 89,608
Accrued royalties 0 0 (1,557)
Operating lease liabilities, net (5,997) (5,863) (5,418)
Deferred taxes 17 (187) 566
Net cash provided by (used in) operating activities 42,032 38,048 (18,388)
Investing activities:      
Maturities of marketable securities 154,671 166,921 256,038
Purchases of marketable securities (145,925) (160,286) (201,165)
Purchase of corporate equity securities 0 (634) (965)
Sale of corporate equity securities 0 0 2,460
Additions of capital expenditures (5,913) (6,484) (8,344)
Acquisition of intangible assets (675) 0 (896)
Acquisition of business, net of cash acquired 0 0 (6,682)
Net cash provided by (used in) investing activities 2,158 (483) 40,446
Financing activities:      
Payment of contingent consideration (1,500) (5,325) (625)
Repurchase and retirement of common stock (87,768) (522) (27,541)
Proceeds from exercise of warrants 0 0 4
Proceeds from exercise of stock options 5,723 8,936 120
Proceeds from issuance of common stock under employee stock purchase plan 2,272 1,397 1,495
Taxes paid related to net share settlement of restricted stock units (12,121) (10,092) (3,059)
Net cash used in financing activities (93,394) (5,606) (29,606)
Effect of exchange rate changes on cash and cash equivalents (90) 532 (112)
Net (decrease) increase in cash, cash equivalents and restricted cash (49,294) 32,491 (7,660)
Cash, cash equivalents, and restricted cash at beginning of period 115,274 82,783 90,443
Cash, cash equivalents, and restricted cash at end of period 65,980 115,274 82,783
Supplemental disclosures of cash information      
Cash paid for income taxes 284 317 738
Supplemental disclosures of non-cash operating, investing and financing information      
Shares issued in lieu of payment 88 174 216
Operating lease right-of-use assets 3,368 195 607
Purchases of capital expenditures in accounts payable and accrued liabilities 3,209 633 647
Employee stock purchase plan shares included in accrued compensation 1,140 975 556
Contingent consideration $ 0 $ 0 $ 3,499
v3.25.4
Organization and Description of Business
 12 Months Ended
Dec. 31, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Organization and Description of Business ORGANIZATION AND DESCRIPTION OF BUSINESS
CareDx Inc. ("CareDx" or the "Company"), together with its subsidiaries, is a precision medicine company dedicated to improving outcomes for transplant patients and advancing organ health. The Company delivers solutions designed to empower clinicians and improve patient outcomes.The Company's integrated solutions include non-invasive molecular testing for heart, kidney, and lung transplants; laboratory products; digital health technologies; and patient solutions that support care before and after transplant. CareDx is the leading provider of genomics-based information for transplant patients. The Company’s headquarters are in Brisbane, California and it has other primary operations in Omaha, Nebraska; and Stockholm, Sweden.
The Company’s commercially available post-transplant testing services consist of AlloSure® Kidney, a donor-derived cell-free DNA, or dd-cfDNA, solution for kidney transplant patients, AlloMap® Heart, a gene expression profiling solution for heart transplant patients, AlloSure® Heart, a dd-cfDNA solution for heart transplant patients, HeartCare, the combined use of AlloMap Heart and AlloSure Heart, and AlloSure® Lung, a dd-cfDNA solution for lung transplant patients. The Company has initiated several clinical studies to generate data on its existing and planned future testing services. The Company has signed multiple biopharma research partnerships for AlloCell, a surveillance solution that monitors the level of engraftment and persistence of allogeneic cells for patients who have received cell therapy. The Company also offers high-quality products in the pre-transplant space that increase the chance of successful transplants by facilitating a better match between a donor and a recipient of stem cells and organs. The Company also provides digital technologies solutions and various offerings that help transplant centers with patient management, outcomes quality and operational support.
v3.25.4
Summary of Significant Accounting Policies
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Summary of Significant Accounting Policies SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES
Basis of Presentation
The accompanying consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America, or U.S. GAAP, and include the accounts of the Company and its subsidiaries. Intercompany transactions have been eliminated.
Certain reclassifications have been made to prior period amounts to conform to current period presentations.
Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts in the Company's consolidated financial statements and accompanying notes. On an ongoing basis, management evaluates its estimates, including those related to transaction price estimates used for testing services revenue; accrued expenses for clinical studies; inventory valuation; the grant date fair value assumptions used to estimate stock-based compensation expense; income taxes; impairment of long-lived assets and indefinite-lived assets (including goodwill); and legal contingencies. Actual results could differ from those estimates.
Concentrations of Credit Risk and Other Risks and Uncertainties
Financial instruments that potentially subject the Company to credit risk consist of cash, cash equivalents and marketable securities. The Company’s policy is to invest its cash and cash equivalents in money market funds, obligations of U.S. government agencies and government-sponsored entities, commercial paper, corporate debt securities and various bank deposit accounts. The counterparties to the agreements relating to the Company’s investments consist of financial institutions of high credit standing. The Company is exposed to credit risk in the event of default by the financial institutions to the extent of amounts recorded on the balance sheets that may be in excess of insured limits.
The Company is also subject to credit risk from its accounts receivable, which are primarily derived from revenue earned from AlloSure Kidney, AlloSure Heart, AlloMap Heart, HeartCare and AlloSure Lung tests provided for patients located in the U.S. and Canada, and billed to various third-party payers, from sales of products to distributors, strategic partners and transplant laboratories in Europe, Asia, the Middle East, Africa, the U.S., Latin America and other geographic regions, and from sales of patient and digital solutions. The Company has not experienced any significant credit losses and does not require collateral on receivables. For the years ended December 31, 2025, 2024 and 2023, approximately 34%, 38% and 40%, respectively, of total revenue was billed to Medicare. No other payers represented more than 10% of total revenue for the years ended December 31, 2025, 2024 and 2023.
As of December 31, 2025 and 2024, approximately 21% and 27%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable at either December 31, 2025 or 2024.
Cash and Cash Equivalents
Cash equivalents consist of short-term, highly liquid investments with original maturities of three months or less from the date of purchase. Cash equivalents consist primarily of amounts invested in money market funds.
Restricted Cash
As a condition of the lease agreements for certain facilities, the Company must maintain letters of credit and certain minimum collateral requirements. The cash used to support these arrangements of $0.6 million is classified as long-term restricted cash on the accompanying consolidated balance sheets.
Marketable Securities
The Company considers all highly liquid investments in securities with a maturity of greater than three months at the time of purchase to be marketable securities. As of December 31, 2025, the Company’s marketable securities consisted of corporate debt securities and U.S government securities. Those with maturities of greater than three months but less than 12 months from the balance sheet date were classified as current assets, while investments with maturities of one year or beyond one year from the balance sheet date are classified as non-current assets on the consolidated balance sheet.
The Company classifies its marketable securities as held-to-maturity at the time of purchase and reevaluates such designation at each balance sheet date. The Company has the positive intent and ability to hold these marketable securities to maturity. Marketable securities are carried at amortized cost and are adjusted for amortization of premiums and accretion of discounts to maturity, which is included in interest income, net, on the consolidated statements of operations. Realized gains and losses and declines in value judged to be other-than-temporary, if any, on marketable securities are included in interest income, net. The cost of securities sold is determined using specific identification.
Inventory
Inventories are stated at the lower of actual purchased cost, determined on an average cost basis, on a first-in, first-out basis, or at net realizable value. Excess and obsolete inventories are determined primarily based on expiration dates and future demand forecasts, and write-downs of excess and obsolete inventories are recorded as a component of cost of product.
Property and Equipment, net
Property and equipment are stated at historical cost, less accumulated depreciation. Property and equipment are depreciated using the straight-line method over the estimated useful lives of the assets. The estimated useful life is generally three to five years for computer, office and laboratory equipment, and seven years for furniture and fixtures. Leasehold improvements are amortized over the shorter of their estimated useful lives or the remaining lease term.
The Company capitalizes certain costs incurred for software developed or obtained for internal use, including hosting arrangements. These costs include software licenses and consulting services, as well as employee payroll and payroll-related costs. Capitalized internal-use software costs are usually amortized over a period of three to seven years.
Business Combinations
The Company determines and allocates the purchase price of an acquired business to the assets acquired and liabilities assumed based on their estimated fair values as of the business combination date, including separately identifiable intangible assets, which are separable from goodwill. The Company bases the estimated fair value of identifiable intangible assets acquired in a business combination on independent valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. The Company allocates any excess purchase price over the estimated fair value assigned to the net tangible and identifiable intangible assets acquired and liabilities assumed to goodwill. The use of alternative valuation assumptions, including estimated revenue projections, growth rates, royalty rates, cash flows, discount rates, estimated useful lives and probabilities surrounding the achievement of contingent milestones could result in different purchase price allocations and amortization expense in current and future periods.
In those circumstances where an acquisition involves a contingent consideration arrangement that meets the definition of a liability under Accounting Standard Codification, or ASC, Topic 480, Distinguishing Liabilities from Equity, the Company recognizes a liability equal to the fair value of the contingent payments that the Company expects to make as of the acquisition date. The Company remeasures this liability each reporting period and records changes in the fair value as a component of operating expenses.
Transaction costs associated with acquisitions are expensed as incurred in general and administrative expenses. Results of operations and cash flows of acquired companies are included in the Company’s operating results from the date of acquisition.
Acquired Intangible Assets
Amortizable intangible assets include customer relationships, developed technology, commercialization rights, trademarks and tradenames and in-process technology assets acquired as part of a business combination or asset acquisition. Intangible assets subject to amortization are amortized over their estimated useful lives. Acquired in-process technology assets are considered to be indefinite-lived until the completion or abandonment of the associated research and development efforts. If and when development is complete, which generally occurs if and when regulatory approval to market a product is obtained, 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.
Impairment of Goodwill, Intangible Assets and Long-lived Assets
Goodwill
Goodwill recorded in a business combination is not subject to amortization. Instead, it is tested for impairment on an annual basis and whenever events or changes in circumstances indicate its carrying amount may not be recoverable. The Company has a single reporting unit and consequently evaluates goodwill for impairment based on an evaluation of the fair value of the Company as a whole.
The Company’s annual impairment test date is December 1st. During the goodwill impairment review, the Company assesses qualitative factors to determine whether it is more likely than not that the fair value of the reporting unit is less than the carrying amount, including goodwill. The qualitative factors include, but are not limited to, macroeconomic conditions, industry and the market considerations, and the Company's overall financial performance. If, after assessing the totality of these qualitative factors, the Company determines that it is not more likely than not that the fair value of the reporting unit is less than the carrying amount, then no additional assessment is deemed necessary. Otherwise, the Company proceeds to compare the estimated fair value of the reporting unit with the carrying value, including goodwill. If the carrying amount of the reporting unit exceeds the fair value, the Company records an impairment loss based on the difference.
When necessary, to determine the reporting unit’s fair value under the quantitative approach, the Company uses a combination of income and market approaches, such as estimated discounted future cash flows of that reporting unit, multiples of earnings or revenues, and analysis of recent sales or offerings of comparable entities. The Company also considers its market capitalization on the date of the analysis to assess the reasonableness of the reporting unit’s fair value.
Indefinite-lived intangible assets
The Company evaluates the carrying value of indefinite-lived intangible assets, related to acquired in-process technology assets and a favorable license agreement.
During the period the assets are considered indefinite-lived, they are tested for impairment on an annual basis, as well as between annual tests if the Company becomes aware of any events or changes in circumstances that would indicate that the fair value of the acquired in-process technology assets and the favorable license agreement are less than their carrying amounts. An impairment loss would be recorded when the fair value of an acquired in-process technology asset and the favorable license agreement are less than the carrying value. If and when development is complete, which generally occurs when the products are made commercially available, the associated acquired in-process technology asset and the favorable license agreement will be deemed finite-lived and will then be amortized based on the estimated useful life.
Finite-lived intangible assets and long-lived assets
The Company evaluates its finite-lived intangible assets and its long-lived assets for indicators of possible impairment when events or changes in circumstances indicate that the carrying amount of an asset group may not be recoverable. The Company then compares the carrying amounts of the asset group with the future net undiscounted cash flows expected to be generated by such asset group. If an impairment exists, the Company measures the impairment based on the excess carrying value of the asset group over the asset group’s fair value determined using discounted estimates of future cash flows. Intangible assets subject to amortization are carried at cost less accumulated amortization. Amortization expenses are recorded to cost of testing services, cost of product, cost of patient and digital solutions, research and development expenses and sales and marketing expenses in the consolidated statements of operations.
Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The Company uses the U.S. GAAP fair value hierarchy, which prioritizes the inputs used in the valuation methodologies in measuring fair value as follows:
•Level 1: Inputs that include quoted prices in active markets for identical assets and liabilities.
•Level 2: Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
•Level 3: Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.
The carrying amounts of certain financial instruments of the Company, including accounts receivable, prepaid expenses and other current assets, accounts payable and accrued liabilities, approximate fair value due to their short maturities. The carrying amount of the contingent consideration liability also represents its fair value.
Leases
The Company determines if an arrangement is or contains a lease at contract inception. For leases with an initial term of 12 months or more, a right-of-use, or ROU, asset, representing the underlying asset during the lease term, and a lease liability, representing the payment obligation arising from the lease, are recognized on the consolidated balance sheet at lease commencement based on the present value of the payment obligation. For operating leases, expense is recognized on a straight-line basis over the lease term. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the ROU asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. The Company also has lease arrangements with lease and non-lease components. The Company does not separate non-lease components from lease components for the Company's facility leases. The Company also elected to apply the short-term lease measurement and recognition exemption in which ROU assets and lease liabilities are not recognized for leases with an initial term of 12 months or less.
The present value of lease payments is determined by using the interest rate implicit in the lease, if that rate is readily determinable; otherwise, the Company uses its incremental borrowing rate. The incremental borrowing rate is determined by using the rate of interest that the Company would pay to borrow on a collateralized basis an amount equal to the lease payments for a similar term and in a similar economic environment.
Revenue
The Company recognizes revenue from testing services, product sales, and patient and digital solutions revenue in the amount that reflects the consideration that it expects to be entitled in exchange for goods or services as it transfers control to its customers. Revenue is recorded considering a five-step revenue recognition model that includes identifying the contract with a customer, identifying the performance obligations in the contract, determining the transaction price, allocating the transaction price to the performance obligations, and recognizing revenue when, or as, an entity satisfies a performance obligation.
Testing Services Revenue
AlloSure Kidney, AlloMap Heart, AlloSure Heart, HeartCare and AlloSure Lung patient tests are ordered by healthcare providers. The Company receives a test requisition form with payer information along with a collected patient blood sample. The Company considers the patient to be its customer and the test requisition form to be the contract. Testing services are performed in the Company’s laboratory. Testing services represent one performance obligation in a contract and are performed when results of the test are provided to the healthcare provider, at a point in time.
The healthcare providers that order the tests and on whose behalf the Company provides testing services are generally not responsible for the payment of these services. The first criterion, identify the contracts(s) with a customer, and the second criterion, identify the performance obligations in the contract, of revenue recognition are satisfied when the Company receives a test requisition form with payer information from the healthcare provider. Generally, the Company bills third-party payers upon delivery of an AlloSure Kidney, AlloMap Heart, AlloSure Heart, HeartCare or AlloSure Lung test result to the healthcare provider. Amounts received may vary amongst payers based on coverage practices and policies of the payer. The Company has used the portfolio approach under ASC Topic 606, Revenue from Contracts with Customers, to identify financial classes of payers. Revenue recognized for Medicare and other contracted payers is based on the agreed current reimbursement rate per test, adjusted for historical collection trends where applicable. The Company estimates revenue for non-contracted payers and self-payers using transaction prices determined for each financial class of payers using a history of reimbursements. This includes analysis of the average reimbursement per test and a percentage of tests reimbursed. These estimates require significant judgment.
The Company monitors revenue estimates at each reporting period based on actual cash collections in order to assess whether a revision to the estimate is required. Changes in transaction price estimates are updated quarterly based on actual cash collected or changes made to contracted rates, the Company's discussions with payers, and other pertinent information. In addition,
consistent with ASC 606-10-25-1, the Company continues to assess whether it is probable that it will collect substantially all of the consideration to which it will be entitled when determining if a contract with a customer exists.
For the years ended December 31, 2025 and 2024, the Company recognized $9.6 million and $17.4 million respectively, in revenue for the tests performed in prior periods, as all performance obligations were satisfied at the time the contract was established.
Refunds Reserve

With respect to revenue recognized related to testing services whereby consideration is expected to be received from third-party payers, the Company recognized a constraint to the estimated variable consideration such that it is not probable that a significant revenue reversal will occur. When assessing the total consideration expected to be received from third-party payers, a certain percentage of revenues is further constrained for estimated refunds.
Certain refunds were recognized in accrued liabilities until they are either paid to the respective third-party payers or it is determined the refund will not ultimately be paid, at which time the related accrual is reduced with a corresponding increase to testing services revenue. During the year ended December 31, 2025, the refunds reserve to third-party payers were recognized and testing services revenue decreased by $3.5 million for amounts the Company estimated that would be refunded to third-party payers.

Product Revenue
Product revenue is recognized from the sale of products to end-users, distributors and strategic partners when all revenue recognition criteria are satisfied. The Company generally has a contract or a purchase order from a customer with the specified required terms, including the number of products ordered. Transaction prices are determinable in the contract. The products are delivered and control is transferred to the customer upon either shipping or delivery, as per the terms of the agreement. There are no further performance obligations related to a contract and revenue is recognized at the point of shipment or delivery consistent with the terms of the contract or purchase order.
Patient and Digital Solutions Revenue
Patient and digital solutions revenue is primarily derived from software as a service, or SaaS, agreements entered into with various transplant centers, which are the Company’s customers for this class of revenue. Digital revenue in connection with software license agreements is recognized at the point in time when control of the license is transferred and made available for the customer's use and benefit. The PCS is recognized ratably over the term of the arrangement beginning on the date when access to the subscription is made available to the customer in accordance with ASC 606.
Software license agreements typically require advance payments from customers upon the achievement of certain milestones. The Company records deferred revenue in relation to these agreements when cash payments are received for which the related revenues have not been recognized because one or more of the revenue recognition criteria have not been met, and generally recognizes revenue over the contractual term, as performance obligations are fulfilled.
In addition, the Company derives patient revenue from medication sales. The medication sales revenue is recognized based on the negotiated contract price with the governmental, commercial and non-commercial payers with any applicable patient co-pay. Based on the individual agreement, the Company recognizes revenue from medication sales when prescriptions are shipped or delivered.
Cost of Testing Services
Cost of testing services reflects the aggregate costs incurred in delivering the Company’s testing services. The components of cost of testing services primarily consist of materials and service costs, direct labor costs, stock-based compensation, equipment and infrastructure expenses associated with testing samples, shipping, logistics and specimen processing charges to collect and transport samples, and allocated overhead including rent, information technology, equipment depreciation, utilities and royalties. Royalties for licensed technology, calculated as a percentage of testing services revenues, are recorded as license fees in cost of testing services at the time the testing services revenues are recognized.
Cost of Product
Cost of product reflects the aggregate costs incurred in delivering the Company’s products to customers. The components of cost of product primarily consist of materials costs, manufacturing and kit assembly costs, direct labor costs, equipment and infrastructure expenses associated with preparing kitted products for shipment, shipping, and allocated overhead including rent, information technology, equipment depreciation and utilities. Cost of product also includes amortization of acquired developed technology and adjustments to inventory values, including write-downs of excess or obsolete inventory.
Cost of Patient and Digital Solutions
Cost of patient and digital solutions primarily consists of personnel-related costs associated with developing, installing and maintaining software, depreciation of servers and equipment, amortization of acquired intangible assets, support of the functionality of the software's platforms, including stock-based compensation expenses, cost of medications and allocated costs of facilities and information technology.
Research and Development Expenses
Research and development expenses, including clinical operations, represent costs incurred to develop diagnostic products and services, high-quality evidence to support the use of the Company’s tests, as well as continued efforts related to improving the Company’s existing products and patient and digital solutions offerings. These expenses include payroll and related expenses, consulting expenses, laboratory supplies, clinical studies and certain allocated expenses as well as amounts incurred under certain collaborative agreements. Research and development costs are expensed as incurred. The Company records accruals for estimated clinical study costs comprised of work performed by contract research organizations based on measure of progress.
Stock-based Compensation
The Company uses the Black-Scholes Model, which requires the use of estimates such as stock price volatility and expected option lives, to value employee stock options. The Company estimates the expected option lives using historical data, estimates volatility using its own historical stock prices, estimates risk-free rates using the implied yield currently available in the U.S. Treasury zero-coupon issues with a remaining term equal to the expected option lives, and estimates dividend yield using the Company’s expectations and historical data. Compensation expense for stock options issued to nonemployees is calculated using the Black-Scholes Model and is recorded over the service performance period using the straight-line attribution method. Options subject to vesting are required to be periodically remeasured over their service performance period, which is generally the same as the vesting period.
The fair value of each restricted stock unit is calculated based upon the closing price of the Company’s common stock on the date of the grant.
The Company's stock-based compensation arrangements vest over a three to four year vesting schedule. The Company expenses its stock-based compensation under the ratable method, which treats each vesting tranche as if it were an individual grant. Compensation expense is recognized on awards ultimately expected to vest and reduced for forfeitures that are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Forfeitures are estimated based on the Company's historical experience.
Income Taxes
The Company accounts for income taxes under the liability method. Under this method, deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to affect taxable income. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts expected to be realized.
The Company assesses all material positions taken in any income tax return, including all significant uncertain positions, in all tax years that are still subject to assessment or challenge by relevant taxing authorities. The Company’s assessment of an uncertain tax position begins with the initial determination of the position’s sustainability and is measured at the largest amount of benefit that is greater than 50 percent likely of being realized upon ultimate settlement. As of each balance sheet date, unresolved uncertain tax positions must be reassessed, and the Company will determine whether (i) the factors underlying the sustainability assertion have changed and (ii) the amount of the recognized tax benefit is still appropriate. The recognition and measurement of tax benefits requires significant judgment. Judgments concerning the recognition and measurement of a tax benefit may change as new information becomes available.
Foreign Currency Translation
The functional currency of the Company’s foreign subsidiaries is the local currency for each entity, including the Swedish Krona and Australian dollar. The revenue and expenses of such subsidiaries have been translated into U.S. dollars at average exchange rates prevailing during the period. Foreign currency translation gains and losses on revenue and expenses are recognized in the consolidated statements of operations. Assets and liabilities have been translated at the rates of exchange on the balance sheet date. The resulting cumulative translation adjustments are reported in other comprehensive income (loss).
Comprehensive Income (Loss)
Comprehensive income (loss) consists of net income (loss) and other income and losses affecting stockholders’ equity that, under U.S. GAAP, are excluded from net income or loss. For the Company, such items consist of foreign currency income and losses on the translation of foreign assets and liabilities.
Recent Accounting Pronouncements
Adopted in the current period
In December 2023, the FASB issued Accounting Standards Update, or ASU, No. 2023-09, Income Taxes (Topic 340): Improvements to Income Tax Disclosures, which requires annual disclosures in the rate reconciliation table to be presented using both percentages and reporting currency amounts, and this table must include disclosure of specific categories. Additional information is required for reconciling items that meet a quantitative threshold. The new guidance also requires enhanced disclosures of income taxes paid, including the amount of income taxes paid disaggregated by federal, state and foreign taxes and the amount of income taxes paid disaggregated by individual jurisdictions that exceed a quantitative threshold. The Company adopted this ASU on a prospective basis effective January 1, 2025. Refer to Note 12, Income Taxes.
Effective in Future Periods
In December 2025, the Financial Accounting Standards Board, or FASB, issued ASU 2025-11, Narrow-Scope Improvements (Topic 270): Interim Reporting. This update makes targeted, narrow-scope improvements to the interim reporting guidance in Topic 270 to clarify application and improve consistency in practice. The amendments do not change the underlying principles of interim reporting. The amendments in this ASU are effective for interim reporting periods within annual reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company expects to adopt the guidance in its Form 10-Q for the interim period ending March 31, 2028. The Company is currently evaluating the provisions of this ASU and does not expect to have a material impact on its consolidated financial statements.
In December 2025, the FASB issued ASU 2025-12, Codification Improvements, or ASU 2025-12. ASU 2025-12 addresses suggestions received from stakeholders regarding the Accounting Standards Codification and makes other incremental improvements to U.S. GAAP. The update represents changes to the Codification that clarify, correct errors in or make other improvements to a variety of topics that are intended to make it easier to understand and apply. ASU 2025-12 is effective for fiscal years beginning after December 15, 2026 and interim periods within those fiscal years. Entities are required to apply the amendments to ASC 260 retrospectively. Amendments to all other ASC topics may be applied prospectively or retrospectively. Early adoption is permitted. The Company is currently evaluating the provisions of this ASU and does not expect to have a material impact on its consolidated financial statements.
In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures. This standard requires entities to disaggregate certain costs and expenses into specific categories and by relevant expense caption in the statement of operations. This guidance will be effective for the Company's annual disclosures for the fiscal year ending December 31, 2027 and for interim period disclosures beginning in the fiscal year ending December 31, 2028. The Company is currently evaluating the potential impact of the new standard on its consolidated financial statements and related disclosures.
In September 2025, the FASB issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. This standard modernizes the accounting guidance for internal-use software costs to better reflect current development practices, including agile and iterative methodologies. This guidance is effective for fiscal years beginning after December 15, 2027, including interim periods within those fiscal years. The Company is currently evaluating the provisions of this ASU and does not expect to have a material impact on its consolidated financial statements.
v3.25.4
Net (Loss) Income Per Share
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Net (Loss) Income Per Share NET (LOSS) INCOME PER SHARE
Basic and diluted net (loss) income per share have been computed by dividing the net (loss) income by the weighted-average number of common shares outstanding during the period.
For the years ended December 31, 2025, and 2023 common share equivalents have been excluded from the calculation of diluted net loss per share, as their effect would be antidilutive.
For the year ended December 31, 2024, all common share equivalents have been included in the calculation of diluted net income per share.
The following tables set forth the computation of the Company’s basic and diluted net (loss) income per share (in thousands, except shares and per share data):
 Year Ended December 31,
 202520242023
Numerator:   
Net (loss) income used to compute basic and diluted net (loss) income per share
$(21,354)$52,549 $(190,284)
Denominator:
Weighted-average shares used to compute basic net (loss) income per share
53,287,546 52,773,247 53,764,705 
Weighted-average shares used to compute diluted net (loss) income per share
53,287,546 56,620,590 53,764,705 
Net (loss) income per share:
Basic$(0.40)$1.00 $(3.54)
Diluted$(0.40)$0.93 $(3.54)
The following potentially dilutive securities have been excluded from diluted net (loss) income per share because their effect would be antidilutive:
Year Ended December 31,
202520242023
Shares of common stock subject to outstanding options
2,478,871 2,496,063 3,055,208 
Restricted stock units3,930,939 543,479 5,001,370 
Employee stock purchase plan
61,866 66,747 73,759 
Total common stock equivalents6,471,676 3,106,289 8,130,337 
v3.25.4
Fair Value Measurements
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
Fair Value Measurements FAIR VALUE MEASUREMENTS
The following table sets forth the Company’s financial assets and liabilities, measured at fair value on a recurring basis, as of December 31, 2025 and 2024 (in thousands):
December 31, 2025
Fair Value Measured Using
(Level 1)(Level 2)(Level 3)Total Balance
Assets
Cash equivalents:
Money market funds$21,435 $— $— $21,435 
Total$21,435 $— $— $21,435 
Liabilities
Short-term liabilities:
Contingent consideration$— $— $1,617 $1,617 
Long-term liabilities:
Contingent consideration— — 161 161 
Total$— $— $1,778 $1,778 
December 31, 2024
Fair Value Measured Using
(Level 1)(Level 2)(Level 3)Total Balance
Assets
Cash equivalents:
Money market funds$52,230 $— $— $52,230 
Total$52,230 $— $— $52,230 
Liabilities
Short-term liabilities:
Contingent consideration$— $— $2,414 $2,414 
Long-term liabilities:
Contingent consideration— — 174 174 
Total $— $— $2,588 $2,588 
The following table presents the exercise, changes in estimated fair value, additions, deduction and payments of the Company’s Level 3 financial instruments that are measured at fair value on a recurring basis (in thousands):
(Level 3)
Contingent Consideration
Balance at December 31, 2023
$7,930 
Change in estimated fair value of contingent consideration from business combination
931 
Change in estimated fair value of contingent consideration from asset acquisition
(448)
Deduction from contingent consideration
(500)
Payment related to contingent consideration(5,325)
Balance at December 31, 2024
2,588 
Change in estimated fair value of contingent consideration from business combination
704 
Change in estimated fair value of contingent consideration from asset acquisition
(14)
Payment related to contingent consideration(1,500)
Balance at December 31, 2025
$1,778 
In determining fair value, the Company uses various valuation approaches within the fair value measurement framework. The valuation methodologies used for the Company’s instruments measured at fair value and their classification in the valuation hierarchy are summarized below:
•Money market funds – Investments in money market funds are classified within Level 1. Money market funds are valued at the closing price using the fund's net asset value reported by the fund sponsor, utilizing actively traded exchange information. At December 31, 2025 and 2024, money market funds were included as cash and cash equivalents in the consolidated balance sheets.
•Contingent consideration – Contingent consideration is classified within Level 3. Contingent consideration relates to asset acquisitions and business combinations. The Company recorded the estimate of the fair value of the contingent consideration based on its evaluation of the probability of the achievement of the contractual conditions that would result in the payment of the contingent consideration. Contingent consideration was estimated using the fair value of the milestones to be paid if the contingency is met based on management’s estimate of the probability of success and projected revenues for revenue-based considerations at discounted rates of 7% at December 31, 2025 and 7% to 12% at December 31, 2024. The significant input in the Level 3 measurement that is not supported by market activity is the Company’s probability assessment of the achievement of the milestones. The value of the liability is subsequently remeasured to fair value at each reporting date, and the change in estimated fair value is recorded as income or expense within operating expenses in the consolidated statements of operations until the milestones are paid, expire or are no longer achievable. Increases or decreases in the estimation of the probability percentage result in a directionally similar impact on the fair value measurement of the contingent consideration liability. The carrying amount of the contingent consideration liability represents its fair value.
v3.25.4
Cash and Marketable Securities
 12 Months Ended
Dec. 31, 2025
Cash and Cash Equivalents [Abstract]  
Cash and Marketable Securities CASH AND MARKETABLE SECURITIES
Cash, Cash Equivalents and Restricted Cash
A reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the amount reported within the consolidated statements of cash flows is shown in the table below (in thousands):
December 31, 2025December 31, 2024December 31, 2023
Cash and cash equivalents$65,429 $114,689 $82,197 
Restricted cash551 585 586 
Total cash, cash equivalents, and restricted cash at the end of the period$65,980 $115,274 $82,783 
Marketable Securities
All marketable securities were considered held-to-maturity at December 31, 2025 and 2024. The Company determined that it had the positive intent and ability to hold until maturity all marketable securities. The Company assesses whether the decline in value of marketable securities is temporary or other-than-temporary. In making its assessment, the Company evaluates the current market and interest rate environment as well as specific issuer information. There has been no recognition of any other-than-temporary impairment at December 31, 2025 and 2024.
The amortized cost, unrealized holding gains, and fair value of the Company’s marketable securities by major security type at each balance sheet date are summarized in the tables below (in thousands):
December 31, 2025
Amortized CostUnrealized Holding GainsFair Value
Marketable securities:
U.S. agency securities$81,196 $595$81,791 
Corporate debt securities54,748 5754,805 
Total marketable securities
$135,944 $652$136,596 
December 31, 2024
Amortized Cost
Unrealized Holding Gains
Fair Value
Marketable securities:
U.S. agency securities$90,918 $1,648 $92,566 
Corporate debt securities55,046 718 55,764 
Total marketable securities
$145,964 $2,366 $148,330 
As of December 31, 2025, $24.2 million of marketable securities had maturities of more than one year and less than two years and are classified as non-current assets.
v3.25.4
Goodwill and Intangible Assets
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets GOODWILL AND INTANGIBLE ASSETS
Goodwill
On December 1, 2025, the Company performed a qualitative assessment of its reporting unit taking into consideration past, current and projected future earnings, recent trends and market conditions, and its market capitalization. Based on this analysis, the Company concluded that it was more likely than not that the fair value of the reporting unit exceeded its carrying amount. As such, it was not necessary to perform the quantitative goodwill impairment assessment at this time. As of December 31, 2025, 2024 and 2023, there has been no impairment of goodwill.
Intangible Assets
The following table presents details of the Company’s intangible assets as of December 31, 2025 ($ in thousands):
December 31, 2025
Gross
Carrying
Amount
Accumulated
Amortization
Foreign
Currency
Translation
Net Carrying
Amount
Weighted
Average
Remaining
Useful Life
(In Years)
Intangible assets with finite lives:
Acquired and developed technology$36,517 $(24,127)$(2,203)$10,187 5.8
Customer relationships25,581 (12,413)(1,639)11,529 7.1
Commercialization rights11,579 (7,022)— 4,557 3.6
Trademarks and tradenames4,860 (2,434)(232)2,194 6.6
Total intangible assets with finite lives78,537 (45,996)(4,074)28,467 
Intangible assets with indefinite lives:
Acquired in-process technology1,250 — — 1,250 
Favorable license agreement2,243 — — 2,243 
Total intangible assets with indefinite lives3,493 — — 3,493 
Total intangible assets$82,030 $(45,996)$(4,074)$31,960 
The following table presents details of the Company’s intangible assets as of December 31, 2024 ($ in thousands):
December 31, 2024
Gross
Carrying
Amount
Accumulated
Amortization
Foreign
Currency
Translation
Net Carrying
Amount
Weighted
Average
Remaining
Useful Life
(In Years)
Intangible assets with finite lives:
Acquired and developed technology$37,367 $(21,357)$(2,531)$13,479 6.6
Customer relationships25,718 (10,777)(2,332)12,609 8.4
Commercialization rights11,579 (5,760)— 5,819 4.6
Trademarks and tradenames5,220 (2,094)(356)2,770 8.5
Total intangible assets with finite lives79,884 (39,988)(5,219)34,677 
Acquired in-process technology1,250 — — 1,250 
Favorable license agreement2,257 — — 2,257 
Total intangible assets with indefinite lives3,507 — — 3,507 
Total intangible assets$83,391 $(39,988)$(5,219)$38,184 
As of December 31, 2025, 2024 and 2023, other than the $1.7 million intangible asset that was impaired and written off under general and administrative expenses during the year ended December 31, 2025, the Company did not identify any impairment indicators suggesting that the carrying value of the intangible assets was not recoverable.
The following table summarizes the Company's amortization expense of intangible assets (in thousands):
Year Ended December 31,
202520242023
Cost of testing services$1,388 $1,316 $1,316 
Cost of product1,751 1,660 1,655 
Cost of patient and digital solutions610 850 1,039 
Sales and marketing2,602 2,520 2,457 
Total $6,351 $6,346 $6,467 
The following table summarizes the Company’s estimated future amortization expense of intangible assets with finite lives as of December 31, 2025 (in thousands):
Years Ending December 31,Total
2026$5,332 
20275,319 
20285,319 
20294,604 
20303,535 
Thereafter4,358 
Total future amortization expense$28,467 
v3.25.4
Balance Sheet Components
 12 Months Ended
Dec. 31, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Balance Sheet Components BALANCE SHEET COMPONENTS
Inventory
Inventory consisted of the following (in thousands):
December 31,
20252024
Finished goods$9,804 $4,819 
Work in progress3,740 3,793 
Raw materials13,161 10,891 
Total inventory$26,705 $19,503 
Property and Equipment, Net
Property and equipment consisted of the following (in thousands):
December 31,
20252024
Internally developed software23,016 13,843 
Machinery and equipment$19,110 $18,771 
Leasehold improvements18,171 18,106 
Construction in progress8,280 11,937 
Computer and office equipment1,676 5,650 
Furniture and fixtures1,569 2,187 
Property and equipment71,822 70,494 
Less: Accumulated depreciation and amortization(38,851)(36,942)
Property and equipment, net$32,971 $33,552 
Depreciation expense was $8.7 million, $7.8 million and $7.9 million for the years ended December 31, 2025, 2024 and 2023, respectively.
Accrued and Other Liabilities
Accrued and other liabilities consisted of the following (in thousands):
December 31,
20252024
Clinical studies$12,356 $16,166 
Short-term lease liability6,515 6,103 
Professional fees4,988 5,971 
Deferred revenue4,653 4,848 
Refunds reserve
3,500 — 
Laboratory processing fees and materials2,425 3,184 
Other accrued expenses7,317 7,080 
Total accrued and other liabilities$41,754 $43,352 
v3.25.4
Commitments and Contingencies
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies COMMITMENTS AND CONTINGENCIES
Leases
The Company leases its operating and office facilities for various terms under long-term, non-cancelable operating lease agreements in Brisbane, California; West Chester, Pennsylvania; Flowood, Mississippi; Omaha, Nebraska; Fremantle, Australia; and Stockholm, Sweden.
The Company's facility leases expire at various dates through 2033. In the normal course of business, it is expected that these leases will be renewed or replaced by leases on other properties.
As of December 31, 2025, the carrying value of the ROU asset was $22.8 million. The related current and non-current lease liabilities as of December 31, 2025 were $6.5 million and $19.7 million, respectively. The current and non-current lease liabilities are included in accrued and other liabilities and operating lease liabilities, less current portion, respectively, in the consolidated balance sheets.
The following table summarizes the lease cost for the years ended December 31, (in thousands):
202520242023
Operating lease cost$7,340 $7,717 $7,936 
Total lease cost$7,340 $7,717 $7,936 
December 31,
20252024
Other information:
Weighted-average remaining lease term - Operating leases (in years)4.024.61
Weighted-average discount rate - Operating leases (%)7.0 %7.1 %
Supplemental cash flow information related to leases for the years ended December 31, are as follows (in thousands):
202520242023
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows used for operating leases$6,055 $5,339 $5,454 
Total$6,055 $5,339 $5,454 
Maturities of operating lease liabilities as of December 31, 2025, are as follows (in thousands):
Years ending December 31,Operating Leases
2026$7,905 
20278,248 
20287,573 
20292,581 
20301,768 
Thereafter1,715 
Total lease payments29,790 
Less imputed interest3,596 
Present value of future minimum lease payments26,194 
Less operating lease liability, current portion6,515 
Operating lease liability, long-term portion$19,679 
As of December 31, 2025, the Company’s leases had remaining terms of 0.41 years to 7.09 years, some of which include options to extend the lease term.
Royalty Commitments
Illumina
On May 4, 2018, the Company entered into a license agreement with Illumina, Inc., or the Illumina Agreement. The Illumina Agreement requires the Company to pay royalties in the mid-single to low-double digits on sales of products covered by the Illumina Agreement.
Other Royalty Commitment
Effective as of August 2023, the Company entered into a license agreement with a university institution, or the University Agreement. The University Agreement requires the Company to pay royalties in the low single digits on sales of products covered by the University Agreement.
Other Commitments
Effective as of July 2023, the Company entered into a license and collaboration agreement with a private entity, or the Collaboration Agreement, pursuant to which the Company was granted an irrevocable, non-transferable right to commercialize its proprietary software, iBox, for the predictive analysis of post-transplantation kidney allograft loss in the field of transplantation for a period of four years with exclusive rights in the United States. Pursuant to the Collaboration Agreement, the Company will share an agreed-upon percentage of revenue with the private entity, if and when revenues are generated from iBox.
Litigation and Indemnification Obligations
From time to time, the Company may become involved in litigation and other legal actions. The Company estimates the range of liability related to any pending litigation where the amount and range of loss can be estimated. The Company records its best estimate of a loss when the loss is considered probable. Where a liability is probable and there is a range of estimated loss with no best estimate in the range, the Company records a charge equal to at least the minimum estimated liability for a loss contingency when both of the following conditions are met: (i) information available prior to issuance of the consolidated financial statements indicates that it is probable that a liability had been incurred at the date of the consolidated financial statements, and (ii) the range of loss can be reasonably estimated.
Natera
In response to the Company’s false advertising suit filed against Natera Inc., or Natera, on April 10, 2019, Natera filed a counterclaim against the Company on February 18, 2020, in the U.S. District Court for the District of Delaware, or the Court, alleging the Company made false and misleading claims about the performance capabilities of AlloSure. The suit seeks injunctive relief and unspecified monetary relief. On September 30, 2020, Natera requested leave of Court to amend its counterclaims to include additional allegations regarding purportedly false claims the Company made with respect to AlloSure, and the Court granted Natera’s request. The trial commenced on March 7, 2022 and concluded on March 14, 2022, with the jury finding that Natera violated the Lanham Act by falsely advertising the scientific performance of its Prospera transplant test
and awarding the Company $44.9 million in damages, comprised of $21.2 million in compensatory damages and $23.7 million in punitive damages. In July 2023, the Court upheld and reaffirmed the March 2022 jury verdict but did not uphold the monetary damages awarded by the jury. In August 2023, the Court issued an injunction prohibiting Natera from making the claims the jury previously found to be false advertising. Both parties appealed. On October 8, 2024, the U.S. Court of Appeals for the Third Circuit remanded the case to make additional findings. On December 23, 2024, the Court issued an order concluding that there was sufficient evidence to support the jury’s findings of falsity on eight advertisements by Natera. Following the decision, the parties submitted additional briefing to the Court. On August 28, 2025, the U.S. Court of Appeals for the Third Circuit issued a decision affirming the District Court’s findings on both liability and damages. On September 25, 2025, the Company filed a petition for panel rehearing or rehearing en banc of the Court’s damages decision. On October 10, 2025, the Third Circuit denied the petition. On February 9, 2026, the Company filed a petition for Supreme Court review. The Company did not record a receivable or a gain from the judgment as the amount has not yet been realized.
In addition, Natera filed suit against the Company on January 13, 2020, in the Court alleging, among other things, that AlloSure infringes Natera’s U.S. Patent 10,526,658. This case was consolidated with the Company’s patent infringement suit on February 4, 2020. On March 25, 2020, Natera filed an amendment to the suit alleging, among other things, that AlloSure also infringes Natera’s U.S. Patent 10,597,724. The suit seeks a judgment that the Company has infringed Natera’s patents, an order preliminarily and permanently enjoining the Company from any further infringement of such patents and unspecified damages. On May 13, 2022, Natera filed two new complaints alleging that AlloSure infringes Natera’s U.S. Patents 10,655,180 and 11,111,544. These two cases were consolidated with the patent infringement case on June 15, 2022. On May 17, 2022, Natera agreed to dismiss the case alleging infringement of Natera’s U.S. Patent 10,526,658. On July 6, 2022, the Company moved to dismiss the rest of Natera’s claims. On September 6, 2022, the Company withdrew its motion to dismiss. On December 11, 2023, the Court dismissed the case alleging infringement of Natera's U.S. Patent 10,597,724. Natera appealed that decision. On March 13, 2024, the Federal Circuit dismissed Natera's appeal after Natera failed to file its brief and other required papers. On May 30, 2024, Natera filed a second notice of appeal of the dismissal of U.S. Patent 10,597,724. On June 19, 2024, the Company moved to dismiss Natera's appeal. On September 11, 2024, the Federal Circuit denied that motion.
On January 26, 2024, following a five-day trial, a jury concluded that the Company did not infringe Natera's U.S. Patent 10,655,180 but did infringe Natera's U.S. Patent 11,111,544. The jury awarded Natera approximately $96.3 million in damages based on sales of AlloSure and AlloSeq between September 2021 and August 2023. Natera's U.S. Patent 11,111,544 expires in September 2026. Following trial, Natera moved for an injunction on the Company's prior AlloSure process and the parties engaged in motion practice regarding the jury's verdict and discovery as to whether the Company’s current AlloSure process infringes Natera's U.S. Patent 11,111,544. On September 11, 2024, Natera informed the Court that it was abandoning claims of ongoing infringement. On January 3, 2025, the Court issued an order denying Natera’s motion to set aside the jury’s finding that the Company did not infringe Natera's U.S. Patent 10,655,180. On February 24, 2025, the Court issued an order concluding that Natera's U.S. Patents 11,111,544 and 10,655,180 were invalid for lack of written description thereby overturning the jury verdict. On February 25, 2025, the Court issued an order denying Natera's motion for an injunction as moot. Natera has appealed the Court's invalidation of the three patents it asserted against CareDx. The Company intends to defend these matters vigorously, and believes that the Company has good and substantial defenses to the claims alleged in the suits, but there is no guarantee that the Company will prevail.
In addition, Natera's U.S. Patent 10,597,724 is currently subject to an ex parte reexamination before the United States Patent and Trademark Office, or PTO. On December 17, 2025, a PTO examiner issued a non-final office action rejecting Claims 1 and 4-6 of the patent. Natera's U.S. Patent 11,111,544 was previously subject to an ex parte reexamination before the PTO. On February 14, 2025, a PTO examiner issued a non-final Office action rejecting Claims 21, 26, and 27 of the patent, the claims CareDx was found to have infringed in the litigation. On July 9, 2025, the PTO issued a reexamination certificate finding that Natera had overcome the prior rejections of the 11,111,544 patent, concluding the reexamination proceeding.
After the jury finding, the Company recognized the damages of $96.3 million as other liabilities on the consolidated balance sheets as of December 31, 2023 as the loss was probable and reasonably estimable at that time. After the Court order overturned the jury finding, the Company derecognized the $96.3 million as of December 31, 2024 as the Company concluded that the loss was no longer probable. It is reasonably possible that the Company may not prevail if Natera continues to pursue the case through appeal, in which case the range of loss could be up to the jury awarded amount of $96.3 million plus potential interest.
United States Department of Justice and United States Securities and Exchange Commission Investigations
As previously disclosed, in 2021, the Company received a civil investigative demand, or CID, from the United States Department of Justice, or DOJ, requesting that the Company produce certain documents in connection with a False Claims Act investigation by the DOJ regarding certain business practices related to the Company’s kidney testing and phlebotomy services, and a subpoena from the United States Securities and Exchange Commission, or the SEC, in relation to an investigation by the SEC in respect of matters similar to those identified in the CID, as well as certain of the Company’s accounting and public reporting practices. By letter dated September 19, 2023, the Company was notified by the staff of the SEC that the SEC has
concluded its investigation as to the Company and does not intend to recommend an enforcement action by the SEC against the Company. The notice was provided under the guidelines set out in the final paragraph of Securities Act Release No. 5310.
In a court document unsealed on October 7, 2024, the DOJ notified the United States District Court for the Eastern District of New York that it was declining to intervene in a qui tam action filed against the Company by a former employee that served as the basis for the CID. Accordingly, CareDx understands that the DOJ has closed its investigation of the Company with no finding of wrongdoing. On April 8, 2025, the private plaintiff who originally filed the qui tam action in 2021, or the Relator, filed an amended complaint on the public docket. On July 16, 2025, the District Court held a conference, at which it set a briefing schedule for a motion to dismiss. On October 17, 2025, Relator filed an opposition to the Company’s motion to dismiss, and on October 31, 2025, the Company filed its reply in further support of its motion to dismiss. The Company denies the allegations in the qui tam action and intends to vigorously defend itself.
The Company may receive additional requests for information from the DOJ, the SEC, or other regulatory and governmental agencies regarding similar or related subject matters. Although the Company remains committed to compliance with all applicable laws and regulations, it cannot predict the outcome of, or any other requests or investigations that may arise, in the future.
Securities Class Action
On May 23, 2022, Plumbers & Pipefitters Local Union #295 Pension Fund filed a federal securities class action, or the Securities Class Action, in the U.S. District Court for the Northern District of California against the Company, Reginald Seeto, its former President, Chief Executive Officer and member of the Company’s Board of Directors, Ankur Dhingra, its former Chief Financial Officer, Marcel Konrad, its former interim Chief Financial Officer and former Senior Vice President of Finance & Accounting, and Peter Maag, its former President, former Chief Executive Officer, former Chairman of the Company’s Board of Directors and current member of the Company’s Board of Directors. The action alleges that the Company and the individual defendants made materially false and/or misleading statements and/or omissions and that such statements violated Section 10(b) of the Securities Exchange Act of 1934, as amended, or the Exchange Act, and Rule 10b-5 promulgated thereunder. The action also alleges that the individual defendants are liable pursuant to Section 20(a) of the Exchange Act as controlling persons of the Company. The suit seeks to recover damages caused by the alleged violations of federal securities laws, along with the plaintiffs’ costs incurred in the lawsuit, including their reasonable attorneys’ and experts’ witness fees and other costs.
On August 25, 2022, the court appointed an investor group led by the Oklahoma Police Pension and Retirement System as lead plaintiffs and appointed Saxena White P.A. and Robbins Geller Rudman & Dowd LLP as lead counsels. Plaintiffs filed an amended complaint on November 28, 2022. On January 27, 2023, defendants moved to dismiss all claims and to strike certain allegations in the amended complaint.
On May 24, 2023, the court granted the Company’s motion to strike and motion to dismiss, dismissing all claims against defendants with leave to amend. On June 28, 2023, plaintiffs filed a second amended complaint against the Company, Reginald Seeto, Ankur Dhingra, and Peter Maag. Under a briefing schedule ordered by the court on June 12, 2023, defendants’ motion to dismiss and motion to strike the second amended complaint was filed on July 26, 2023, plaintiffs’ opposition was filed on August 30, 2023, and defendants’ reply was filed on September 22, 2023. The court held oral argument on October 31, 2023.
On September 18, 2024, the court granted the Company’s motion to dismiss the second amended complaint without prejudice, providing plaintiffs leave to file a third amended complaint by no later than October 2, 2024 (a deadline which was subsequently extended by stipulation). On October 18, 2024, plaintiffs filed a third amended complaint, which again alleges that the Company and the individual defendants made materially false and/or misleading statements and/or omissions in violation of Section 10(b) of the Exchange Act, and Rule 10b-5 promulgated thereunder, and Section 20(a) of the Exchange Act. Among other things, plaintiffs removed former Chief Financial Officer, Ankur Dhingra, as a named defendant. The third amended complaint reiterates many of the same factual allegations as in prior complaints, but purports to add new allegations based on, among other things, a recently unsealed qui tam action filed by a former employee. On November 15, 2024 the defendants filed a motion to dismiss the third amended complaint and on December 13, 2024, plaintiffs filed an opposition brief. On January 10, 2025, defendants filed their reply brief and a hearing was held on January 28, 2025. On February 18, 2025, the court denied the defendant’s motion to dismiss the third amended complaint.
On April 1, 2025, a mediation was held between the parties to the Securities Class Action with the assistance of Phillips ADR Enterprises.
On April 22, 2025, the parties in the Securities Class Action reached an agreement-in-principle to resolve the Securities Class Action under which the Company would pay or cause to be paid a settlement payment of approximately $20.25 million. On May 16, 2025, the parties reached a definitive stipulation of settlement. On May 23, 2025, plaintiffs filed a motion for preliminary approval. On July 23, 2025, the District Court issued an order preliminarily approving the settlement triggering the Company's obligation to fund its portion of the settlement. Pursuant to the settlement agreement, the Company and its insurers each deposited their respective obligations into an escrow account.
In accordance with the Court’s July 23, 2025 order, plaintiffs filed a motion for final approval and a motion for an award of attorneys’ fees and expenses on September 30, 2025. On December 4, 2025, the Court provided final approval of the settlement and the Company paid the settlement amount.
Derivative Actions
On February 26, 2025, the plaintiffs in a previously-dismissed consolidated derivative action initiated a new action, captioned Edelman v. Bickerstaff, 3:25-c-02036 (N.D. Cal. filed Feb. 26, 2025), purporting to reinstate their claims and updating and amending their prior complaint, or the Edelman Derivative Action. The Edelman Derivative Action asserts claims against the Company as nominal defendant and Drs. Seeto and Maag and Mr. Dhingra, and other current and former members of the Company's Board of Directors alleging, among other things, breaches of fiduciary duty and various state and federal claims based on the factual allegations of the Securities Class Action.
On March 19, 2025, the parties to the Edelman Derivative Action and the Securities Action filed an administrative motion to consider whether the Edelman Derivative Action should be related to the Securities Class Action. On April 1, 2025, the Court granted the motion.
On April 1, 2025, a mediation was held between the parties to the Edelman Derivative Action with the assistance of Phillips ADR Enterprises. No settlement was reached during the mediation.
On April 10, 2025, the Court held an Initial Case Management Conference in the Edelman Derivative Action and thereafter issued a Case Management and Scheduling Order setting a trial date of July 19, 2027, among other deadlines.
On April 21, 2025, plaintiffs in the Edelman Derivative Action submitted a letter motion to the Court seeking to have the Court lift the discovery stay provided by the Private Securities Litigation Reform Act of 1995, 15 U.S.C. § 78u-4, or the PSLRA. On April 23, 2025, CareDx submitted a brief in opposition and a hearing was held on June 10, 2025. On June 12, 2025, the Court issued an order denying plaintiffs’ letter motion to lift the PSLRA’s discovery stay.
On March 20, 2024, Edward W. Burns IRA filed a stockholder derivative action complaint in the Court of Chancery of the State of Delaware against the Company as nominal defendant and Dr. Seeto, Mr. Dhingra, Dr. Maag, and other current and former members of the Company's Board of Directors, or the Burns Derivative Action. Prior to filing the complaint, the Company produced documents to the plaintiff in response to a books and records inspection demand made pursuant to Section 220 of the Delaware General Corporation Law. The plaintiff purports to incorporate those documents in the complaint. The plaintiff alleges that the individual defendants breached their fiduciary duties as directors and/or officers of the Company and engaged in insider trading, unjust enrichment, waste of corporate assets, and aiding and abetting breaches of fiduciary duty. The suit seeks declaratory relief, recovery of alleged damages sustained by the Company as a result of the alleged violations, equitable relief, restitution, and plaintiff’s costs incurred in the lawsuit, including reasonable attorneys’, accountants’, and experts’ fees, costs, and expenses. On April 11, 2024, the Court entered an order staying the Burns Derivative Action pursuant to a stipulation filed by the parties.
On March 10, 2025, the parties to the Burns Derivative Action filed an amended stipulation and proposed order to continue the stay in that action, which was so-ordered by the Court on the same day. On April 1, 2025, a mediation was held between the parties to the Burns Derivative Action with the assistance of Phillips ADR Enterprises. No settlement was reached. On June 9, 2025, in accordance with the Court’s March 10, 2025 order, the parties submitted a joint status report, informing the Court that subject to Court approval, the Securities Class Action has been settled and that settlement discussions in the Burns and Edelman Derivative Actions were ongoing.
On July 22, 2025, the parties reached an agreement in principle to resolve the case, subject to the negotiation of an agreed-upon attorney fee, and informed the Court. On July 31, 2025, the parties submitted a joint status report, notifying the Court that the parties selected a JAMS mediator to oversee attorney’s fee negotiation.
On September 9, 2025, the parties participated in a mediation session to mediate attorneys’ fees which was unsuccessful. On September 11, 2025, the parties in the Edelman Derivative Action submitted a joint status report notifying the Court that because a request for attorneys’ fees is not evaluated at the preliminary approval stage, plaintiffs intended to file a motion for preliminary approval of the derivative settlement.
On September 26, 2025, the parties entered into a stipulation and agreement of compromise, settlement and release resolving and settling, subject to court approval, both the Edelman and Burns Derivative Actions. The same day, plaintiffs in the Edelman Derivative Action filed their unopposed motion for preliminary approval. The deadline to oppose the motion was October 10, 2025 and no opposition was filed. On October 13, 2025, plaintiffs filed a notice of non-opposition, requesting that the Court enter an order granting the motion for preliminary approval without oral argument, which is currently scheduled for December 2, 2025 in the Edelman Derivative Action. The motion for preliminary approval remains under consideration.
On October 1, 2025 the parties to the Burns Derivative Action filed a third amended stipulation and proposed order to continue the stay in that action through the pendency of a determination on the proposed settlement in the Edelman Derivative Action. The court entered this stipulated order on October 6, 2025.
On December 9, 2025, the Court issued an order preliminarily approving the parties' settlement, subject to resolution of the plaintiffs' request for attorney's fees.
There is no guarantee that the parties will reach a definitive settlement or, if they do, that the settlement will be approved by the Court. In the event there is no settlement, the Company intends to defend itself vigorously. The Company believes that it has good and substantial defenses to the claims alleged in the suits, but there is no guarantee that the Company will prevail. The Company has not recorded liabilities for these suits.
v3.25.4
Stockholders' Equity
 12 Months Ended
Dec. 31, 2025
Stockholders' Equity Note [Abstract]  
Stockholders' Equity STOCKHOLDERS' EQUITY
Shelf Registration Statement
On May 10, 2023, the Company filed a universal shelf registration statement (File No. 333-271814), or the Registration Statement, and thereafter filed post-effective amendments on May 9, 2024 and May 23, 2024. The SEC declared the Registration Statement effective on May 23, 2024, and as a result, the Company can sell from time to time up to $250.0 million of shares of its common stock, preferred stock, debt securities, warrants, units or rights comprised of any combination of these securities, for the Company’s own account in one or more offerings under the Registration Statement. The terms of any offering under the Registration Statement will be established at the time of such offering and will be described in a prospectus supplement to the Registration Statement filed with the SEC prior to the completion of any such offering.
Stock Repurchase Programs
On February 20, 2025, the Company's Board of Directors approved a Stock Repurchase Program, or the February 2025 Repurchase Program, whereby the Company was authorized to purchase up to $50.0 million in shares of its common stock over a period of up to two years, commencing on February 20, 2025, through open market purchases, one or more Rule 10b5-1 trading plans, block trades and in privately negotiated transactions. During the three months ended June 30, 2025, the Company purchased an aggregate of 3.0 million shares of its common stock under the February 2025 Repurchase Program for an aggregate purchase price of $50.0 million.
Following the completion of the February 2025 Repurchase Program, on May 30, 2025, the Company’s Board of Directors authorized a new share repurchase program of up to $50.0 million in shares of its common stock over a period of up to two years, commencing on May 30, 2025, or the May 2025 Repurchase Program. The May 2025 Repurchase Program may be carried out, subject to approval by a committee of the Company's Board of Directors, through open market purchases, one or more Rule 10b5-1 trading plans, block trades and in privately negotiated transactions. During the year ended December 31, 2025, the Company purchased an aggregate of 2.8 million shares of its common stock under the May 2025 Repurchase Program for an aggregate purchase price of $37.8 million. As of December 31, 2025, $12.2 million was available for future share repurchases under the May 2025 Repurchase Program.
During the year ended December 31, 2025, the Company purchased an aggregate of 5.8 million shares of its common stock under the February 2025 and May 2025 Repurchase Programs, for a total purchase price of $87.8 million.
These shares were retired upon repurchase. The Company's policy related to repurchase of its common stock is to charge the excess of cost over par value to accumulated deficit.
Common Stock
Holders of common stock are entitled to one vote per share on all matters to be voted upon by the stockholders of the Company.
Preferred Stock
As of December 31, 2025 and 2024, the Company had 10,000,000 shares of preferred stock authorized with a par value of $0.001 per share. No shares of preferred stock were outstanding as of December 31, 2025 and 2024.
v3.25.4
401(K) Plan
 12 Months Ended
Dec. 31, 2025
Retirement Benefits [Abstract]  
401(K) Plan 401(K) PLAN
The Company sponsors a 401(k) defined contribution plan covering all U.S. employees under the Internal Revenue Code of 1986, as amended, or the Internal Revenue Code. Employee contributions are voluntary and are determined on an individual basis subject to the maximum allowable under federal tax regulations. The Company incurred expenses related to contributions to the plan of $3.8 million, $2.3 million and $1.7 million for the years ended December 31, 2025, 2024 and 2023, respectively.
v3.25.4
Stock Incentive Plans
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Stock Incentive Plans STOCK INCENTIVE PLANS
2025 Inducement Equity Incentive Plan
On November 4, 2025, the Company adopted the 2025 Inducement Equity Incentive Plan, or the 2025 Plan, that allows for the issuance of stock options, restricted stock units, or RSUs, and other stock awards of up to a total of 350,000 shares of common stock to new employees of the Company. The 2025 Plan was adopted to accommodate a reserve of additional shares of common stock for issuance to new employees hired by the Company. There were 68,745 shares of common stock reserved for future issuance under the 2025 Plan as of December 31, 2025.
2024 Equity Incentive Plan
The Company grants stock-based awards under the 2024 Equity Incentive Plan, or the 2024 Plan, that allows for the issuance of stock options, RSUs and other stock awards to the Company’s employees, directors, and consultants.
On November 4, 2025, the Company increased the shares available under the 2024 Plan by 1,600,000 shares.There were 3,047,496 shares of common stock reserved for future issuance under the 2024 Plan as of December 31, 2025.
2019 Inducement Equity Incentive Plan
The Company grants stock-based awards under the 2019 Inducement Equity Incentive Plan, or the 2019 Plan, that allows for the issuance of stock options, RSUs and other stock awards to new employees of the Company. There were 57,204 shares of common stock reserved for future issuance under the 2019 Plan as of December 31, 2025.
2016 Inducement Plan
On April 21, 2016, the Company adopted the 2016 Inducement Equity Incentive Plan, or the 2016 Plan, that allows for the issuance of stock options, RSUs and other stock awards of up to a total of 155,500 shares of common stock to new employees of the Company. The 2016 Plan was adopted to accommodate a reserve of additional shares of common stock for issuance to new employees hired by the Company from Allenex AB. There were 15,495 shares of common stock reserved for future issuance under the 2016 Plan as of December 31, 2025.
The Company has reserved common stock, on an if-converted basis, for issuance as follows:
December 31,
20252024
Common stock options outstanding
2,478,871 3,409,912 
RSUs and PSUs outstanding
3,930,939 4,842,670 
Remaining shares reserved for issuance under the 2016 Inducement Equity Incentive Plan, 2019 Inducement Equity Incentive Plan, 2024 Equity Incentive Plan and 2025 Inducement Equity Plan
3,188,940 4,559,101 
Shares reserved under the Employee Stock Purchase Plan
541,706 558,787 
Total
10,140,456 13,370,470 
Stock Options
There were no stock options granted to employees during 2025.
The following table summarizes stock option activity during the year ended December 31, 2025:
Number of Shares
Weighted-Average Exercise Price
Stock options outstanding at December 31, 2024
3,409,912 $22.63 
Exercised
(356,383)$16.06 
Forfeited
(91,159)$24.56 
Expired
(483,499)$37.70 
Stock options outstanding at December 31, 2025
2,478,871 $20.47 
Stock options exercisable at December 31, 2025
1,836,376 $22.48 
The total intrinsic value of options exercised was $1.5 million, $4.8 million and $0.1 million for the years ended December 31, 2025, 2024 and 2023, respectively.
Options outstanding that have vested and are expected to vest at December 31, 2025 are as follows:
Number of
Options Issued
Weighted Average Exercise
Price
Weighted
Average
Remaining
Contractual Life
(Years)
Aggregate
Intrinsic Value
(In thousands)
Vested1,836,376 $22.48 5.77$6,725 
Expected to Vest588,205 14.75 7.864,084 
Total2,424,581 $10,809 
The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of the Company’s common stock at December 31, 2025 for stock options that were in-the-money.
Restricted Stock Units and Performance Restricted Stock Units
The following table summarizes RSUs and performance restricted stock units, or PSUs, activity during the year ended December 31, 2025:
Number of Shares
Weighted-Average Grant Date Fair Value
RSUs and PSUs outstanding at December 31, 2024
4,842,670 $15.38 
RSUs granted
1,853,239 $18.38 
RSUs vested
(1,765,017)$15.98 
RSUs forfeited
(913,873)$14.35 
PSUs granted
270,405 $18.99 
PSUs vested
(300,318)$15.05 
PSUs forfeited
(56,167)$25.41 
RSUs and PSUs outstanding at December 31, 2025
3,930,939 $15.54 
The total fair value of RSUs vested during 2025 was $31.8 million. As of December 31, 2025, the total intrinsic value of outstanding RSUs was approximately $68.9 million.
The Company granted PSUs, included in RSUs, under the stock incentive plans. The PSUs granted to employees consist of financial and operational metrics to be met over a performance period of two years. The number of shares, based on expected performance achievement, underlying outstanding PSUs was 226,183 and 335,583 as of December 31, 2025 and December 31, 2024, respectively. The weighted-average remaining recognition period was 2.09 years and 1.07 years for the years ended December 31, 2025 and 2024, respectively.
2014 Employee Stock Purchase Plan
The Company has an Employee Stock Purchase Plan, or the ESPP, under which employees can purchase shares of its common stock based on a percentage of their compensation, but not greater than 15% of their respective earnings, provided that an eligible employee’s right to purchase shares of the Company’s common stock may not accrue at a rate which exceeds $25,000 of the fair market value of such shares for each calendar year in which such rights are outstanding. The ESPP has consecutive offering periods of approximately six months in length. The purchase price per share must be equal to the lower of 85% of the fair value of the common stock on the first day of the offering period or on the exercise date.
During the offering period in 2025 that ended on December 31, 2025, 61,866 shares were purchased for aggregate proceeds of $1.0 million from the issuance of shares, which occurred on January 2, 2026.
During the offering period in 2025 that ended on June 30, 2025, 84,234 shares were purchased for aggregate proceeds of $1.4 million from the issuance of shares, which occurred on June 30, 2025.
During the offering period in 2024 that ended on December 31, 2024, 66,747 shares were purchased for aggregate proceeds of $0.9 million from the issuance of shares, which occurred on January 2, 2025.
The Company issued 150,981 shares and 159,019 shares of common stock during the years ended December 31, 2025 and December 31, 2024, respectively, pursuant to the ESPP. The Company received proceeds of $2.4 million and $1.4 million from the purchases of shares during the years ended December 31, 2025 and 2024, respectively. As of December 31, 2025, the Company had 541,706 shares available for issuance under the ESPP.
Board of Directors Stock Awards Granted for Services
For the years ended December 31, 2025, 2024 and 2023, the Company paid a portion of its directors’ compensation through the award of fully vested common shares. The stock awards are classified as equity, and compensation expense was recognized upon the issuance of the shares at the grant date price per share, which is the fair value. For the years ended December 31, 2025, 2024 and 2023, a total of 4,794, 16,582 and 21,965 shares, respectively, were issued to the Company’s directors for a total fair value of $0.1 million, $0.1 million and $0.2 million, respectively, which was included in general and administrative expense on the consolidated statements of operations.
Valuation Assumptions
The estimated fair values of ESPP shares were estimated using the Black-Scholes option pricing model based on the following weighted average assumptions:
Year Ended December 31,
202520242023
Employee stock purchase plan
Expected term (in years)0.50.50.5
Expected volatility
64.40% – 89.52%
69.60% – 91.99%
75.91% – 93.38%
Risk-free interest rate
3.59% – 4.29%
5.24% – 5.37%
5.26% – 5.47%
Expected dividend yield— %— %— %
Risk-free Interest Rate: The Company based the risk-free interest rate over the expected term of the award based on the constant maturity rate of U.S. Treasury securities with similar maturities as of the date of grant.
Volatility: The Company used an average historical stock price volatility of its own stock.
Expected Term: The expected term represents the period for which the Company’s stock-based compensation awards are expected to be outstanding and is based on analyzing the vesting and contractual terms of the awards and the holders’ historical exercise patterns and termination behavior.
Expected Dividends: The Company has not paid and does not anticipate paying any dividends in the near future.
Stock-Based Compensation Expense
The following table summarizes stock-based compensation expense relating to employee and non-employee stock-based awards for the years ended December 31, 2025, 2024 and 2023, included on the consolidated statements of operations as follows (in thousands):
Year Ended December 31,
202520242023
Cost of testing services$1,263 $1,560 $1,854 
Cost of product464 870 1,165 
Cost of patient and digital solutions624 1,276 1,377 
Research and development5,043 6,501 6,556 
Sales and marketing8,090 11,035 12,470 
General and administrative19,380 45,164 25,664 
Total$34,864 $66,406 $49,086 
As of December 31, 2025, unrecognized stock-based compensation expense related to stock options, RSUs, and PSUs was approximately $5.5 million, $34.8 million, and $2.3 million, respectively. The remaining unrecognized compensation cost related to the unvested stock options, RSUs, and PSUs is expected to be recognized over a weighted-average period of 2.13 years, 2.12 years, and 2.09 years, respectively.
v3.25.4
Income Taxes
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Income Taxes INCOME TAXES
The components of the provision for (benefit from) income taxes are summarized as follows (in thousands):
As of December 31,
202520242023
Pre-tax earnings
Domestic
$(19,128)$55,151 $(188,421)
Foreign
(1,955)(2,292)(1,722)
$(21,083)$52,859 $(190,143)
Current tax expense (benefit)
US federal
$— $2 $(117)
US state & local
420 198 186 
Foreign
— 9 — 
Total current tax expense (benefit)
420 209 69 
Deferred tax expense (benefit)
US federal
$(77)$(10)$184 
US state & local
(11)(26)(112)
Foreign
(61)137 — 
Total deferred tax expense (benefit)
(149)101 72 
Provision for (benefit from) income taxes
$271 $310 $141 
Upon adoption of ASU 2023-09, Improvements to Income Tax Disclosures, as described in Note 2, Summary of Significant Accounting Policies, the Company's actual provision for tax differed from the amounts computed by applying the U.S. federal income tax rate of 21% to pretax income as a result of the following (in thousands, except for percentages):
As of December 31,
2025
Effective tax rate reconciliation
US federal statutory income tax rate
$(4,427)21.0 %
Domestic federal
Tax credits
Research credits(77)0.4 %
Nontaxable and nondeductible items
Non-deductible executive compensation2,217 (10.5)%
Changes in valuation allowances(254)1.2 %
Excess tax benefits on share-based payments(2,115)10.0 %
Other323 (1.5)%
Domestic state and local income taxes, net of federal effect(407)1.9 %
Foreign tax effects350 (1.7)%
Worldwide changes in unrecognized tax benefits4,662 (22.1)%
Total income tax expense (benefit)$271 (1.3)%
The reconciliation of taxes at the federal statutory rate to our provision for (benefit from) income taxes for the years ended December 31, 2024 and 2023 in accordance with the guidance prior to the adoption of ASU 2023-09 was as follows (in millions):
Year ended December 31,
20242023
Federal tax statutory rate21.0 %21.0 %
Stock-based compensation(6.3)%(3.8)%
Change in valuation allowance(18.9)%(18.1)%
Foreign rate differential— %0.2 %
Non-deductible executive compensation9.9 %(0.4)%
Research credits(5.1)%0.4 %
Changes in net operating loss carryforwards, including expirations— %0.8 %
Other— %(0.2)%
Effective income tax rate0.6 %(0.1)%
The Company determines the amount of state tax liability based on current year operations. In accordance with the guidance under ASU 2023-09, California, Pennsylvania, and New York contributed to a majority of the effect of the state income taxes.
Deferred income tax assets and liabilities consist of the following (in thousands):
As of December 31,
20252024
Deferred tax assets:
Net operating loss carryforwards$34,632 $29,839 
Tax credit carryforwards14,42914,045
Accruals8,3225,027
Lease Liability5,5436,843
Section 174 Capitalized Costs24,38133,651
Stock-based compensation15,79316,163
Other1,1301,061
Total deferred tax assets
104,230106,629
Valuation allowance
(92,636)(92,217)
Deferred tax assets, net of valuation allowance
11,59414,412
Deferred tax liabilities:
Purchased intangibles(3,269)(4,828)
Right-of-Use Asset(4,693)(5,858)
Property and equipment(3,363)(3,524)
Other(450)(366)
Total deferred tax liabilities
(11,775)(14,576)
Net deferred tax asset (liability)
$(181)$(164)
The Company assesses the realizability of its net deferred tax assets by evaluating all available evidence, both positive and negative, including (1) cumulative results of operations in recent years, (2) sources of recent losses, (3) estimates of future taxable income and (4) the length of net operating loss carryforward periods. The Company believes that based on the history of its U.S. losses and other factors, the weight of available evidence indicates that it is more likely than not that it will not be able to realize its U.S. net deferred tax assets.
Accordingly, the U.S. and Sweden net deferred tax assets have been offset by a full valuation allowance. The valuation allowance increased by $0.4 million and decreased by $10.6 million during the years ended December 31, 2025 and 2024, respectively.
As of December 31, 2025, the Company had domestic federal net operating loss carryforwards of $130.8 million, domestic state net operating loss carryforwards of $6.2 million, and foreign net operating loss carryforwards of $29.3 million that can reduce future taxable income. The domestic federal and state net operating loss carryforwards will begin to expire in 2026 and 2027, respectively. The foreign and $111 million of federal net operating loss carryforwards can be carried forward indefinitely.
As of December 31, 2025, the Company had credit carryforwards of approximately $12.4 million and $13.9 million available to reduce future taxable income, if any, for domestic federal and California state income tax purposes, respectively. The domestic federal credit carryforwards will begin to expire in 2026. California credits have no expiration date.
A reconciliation of the Company's unrecognized tax benefits is as follows (in thousands):
Year ended December 31,
202520242023
Unrecognized tax benefits
Balance, beginning of year
$8,641 $6,184 $5,436 
Increases related to prior year tax positions
4,587 1,134 — 
Decreases related to prior year tax positions
(525)— (91)
Increases related to current year tax positions
776 1,323 839 
Balance, end of year
$13,479 $8,641 $6,184 
Year ended December 31,
2025
Income taxes paid, net of refunds received
U.S. state & local
284
Total284
None of the $13.5 million of net unrecognized tax benefit as of December 31, 2025, if recognized, would impact the Company's effective tax rate. During the year ended December 31, 2025, given the Company's valuation allowance, the uncertain tax benefits would not have impacted the effective tax rate.
The Company files U.S., state and foreign income tax returns in jurisdictions with varying statutes of limitations. Due to net operating loss and credit carryovers, the domestic federal and state income tax returns are subject to tax authority examination from inception. In the foreign jurisdictions where the Company files income tax returns, the statutes of limitations with respect to these jurisdictions vary from jurisdiction to jurisdiction and range from 4 to 6 years.
As of December 31, 2025, the Company had gross unrecognized tax benefits of $13.5 million which included penalties and interest of $0.2 million, of which approximately $0.2 million is recorded as a noncurrent liability. At this time, the Company is unable to make a reasonably reliable estimate of the timing of payments in individual years in connection with these tax liabilities; therefore, such amounts are not included in the above contractual obligation table.
v3.25.4
Segment Reporting
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Segment Reporting SEGMENT REPORTING
Operating segments are defined as components of an enterprise for which separate financial information is available that is evaluated regularly by the Company’s Chief Operating Decision Maker, or CODM, whose function is to allocate resources to and assess the performance of the operating segments. The Company has identified its President and Chief Executive Officer as the CODM. In determining its reportable segments, the Company considered the markets and types of customers served and the products or services provided in those markets. The Company has determined that it has one operating segment, and therefore, one reportable segment.
Revenue by geographic regions are based upon the customers’ ship-to address for product revenue, the region of testing for testing services revenue and the region where the performance obligation is satisfied for patient and digital solutions revenue. The following table summarizes reportable revenue by geographic regions (in thousands):
Year Ended December 31,
202520242023
Testing services revenue
United States$273,379 $248,247 $209,158 
Rest of World1,116 1,134 527 
$274,495 $249,381 $209,685 
Product revenue
United States$29,908 $26,024 $19,753 
Rest of World18,469 14,759 13,764 
$48,377 $40,783 $33,517 
Patient and digital solutions revenue
United States$56,652 $43,461 $36,719 
Rest of World281 160 403 
$56,933 $43,621 $37,122 
Total revenue
Total United States$359,939 $317,732 $265,630 
Total Rest of World$19,866 $16,053 $14,694 
$379,805 $333,785 $280,324 
The following table summarizes long-lived assets, consisting of property and equipment, net, by geographic regions (in thousands):
December 31, 2025December 31, 2024
Long-lived assets:
United States$32,635 $33,286 
Rest of World336 266 
Total$32,971 $33,552 
The CODM assesses the Company’s performance by using net (loss) income. The CODM uses net income (loss) predominately in the annual budget and forecasting process. The Company's objective in making resource allocation decisions is to optimize the consolidated financial results. The CODM considers budget-to-actual variances on a quarterly basis for the profit measure when making decisions. The CODM organizes the business and leaders functionally. The CODM assesses performance and resources are allocated to functions which utilize those allocations across the business's testing services, products and digital solutions offerings.
The following table summarizes the reconciliation to net (loss) income (in thousands):
Year Ended December 31,
202520242023
Revenue:
Testing services revenue
$274,495 $249,381 $209,685 
Product revenue
48,377 40,783 33,517 
Patient and digital solutions revenue
56,933 43,621 37,122 
Total revenue
379,805 333,785 280,324 
Less:
Cost of testing services1
59,394 52,734 54,472 
Cost of product1
20,738 20,904 15,672 
Cost of patient and digital solutions1
37,007 28,502 23,631 
Personnel cost131,276 116,251 103,354 
Professional and legal fees
41,973 42,655 63,695 
Research materials and clinical trials expense
10,197 14,653 18,277 
Depreciation and amortization expense
12,033 12,455 12,413 
Stock-based compensation expense
34,864 66,406 49,086 
Litigation settlement expense
5,710 (96,300)96,300 
Transformational initiative costs2
2,824 — — 
Other segment items3
54,317 34,741 45,575 
Interest income, net
(9,174)(11,765)(11,867)
Segment and consolidated net (loss) income
$(21,354)$52,549 $(190,284)
1 Cost of testing services, cost of product and cost of patient and digital solutions include depreciation expense.
2 Transformational initiative costs consist of consulting expenses which relate to the Company's ongoing transformation strategy that the Company has undertaken as a series of initiatives focused on operational excellence, enterprise-wide efficiency, and long-term strategic growth, including rebranding costs.
3 Other segment items include the following: restructuring costs, acquisition costs, software expenses, corporate expenses, rent and maintenance expense, travel and event related expense, one-time impairment charge on intangible asset and associated construction in progress, and other expenses (income).
v3.25.4
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2025
shares
Trading Arrangements, by Individual  
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
John W. Hanna [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement
On December 12, 2025, John W. Hanna, our Chief Executive Officer, adopted a trading plan intended to satisfy the conditions under Rule 10b5-1(c) of the Exchange Act. Mr. Hanna’s plan is for the sale of up to 242,434 shares of common stock in amounts and prices determined in accordance with a formula set forth in the plan and terminates on the earlier of the date that all the shares under the plan are sold and March 26, 2027, subject to early termination for certain specified events set forth in the plan.
Name John W. Hanna
Title Chief Executive Officer
Rule 10b5-1 Arrangement Adopted true
Adoption Date December 12, 2025
Expiration Date March 26, 2027
Arrangement Duration 469 days
Aggregate Available 242,434
Hannah Valantine [Member]  
Trading Arrangements, by Individual  
Material Terms of Trading Arrangement
On December 11, 2025, Hannah Valantine, our board member, adopted a trading plan intended to satisfy the conditions under Rule 10b5-1(c) of the Exchange Act. Dr. Valantine’s plan is for the sale of up to 40,882 shares of common stock in amounts and prices determined in accordance with a formula set forth in the plan and terminates on the earlier of the date that all the shares under the plan are sold and December 31, 2026, subject to early termination for certain specified events set forth in the plan.
Name Hannah Valantine
Title board member
Rule 10b5-1 Arrangement Adopted true
Adoption Date December 11, 2025
Expiration Date December 31, 2026
Arrangement Duration 385 days
Aggregate Available 40,882
v3.25.4
Insider Trading Policies and Procedures
 12 Months Ended
Dec. 31, 2025
Insider Trading Policies and Procedures [Line Items]  
Insider Trading Policies and Procedures Adopted true
v3.25.4
Cybersecurity Risk Management and Strategy Disclosure
 12 Months Ended
Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]  
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]
Cybersecurity Risk Management and Strategy
Our cybersecurity risk management strategy focuses on several areas:
•Identification and Reporting: We have implemented a cross-functional approach to assessing, identifying, and managing material cybersecurity threats and incidents. Our program includes controls and procedures to identify, classify, and escalate certain cybersecurity incidents to provide management visibility and obtain direction from management as to the public disclosure and reporting of material incidents in a timely manner.
•Technical Safeguards: We implement technical safeguards that are designed to protect our information systems from cybersecurity threats, including firewalls, intrusion prevention and detection systems, anti-malware functionality, and access controls, which are evaluated and improved through routine vulnerability assessments and cybersecurity threat intelligence, as well as outside audits and certifications.
•Incident Response and Recovery Planning: We have established and maintain an incident response plan designed to address our response to a cybersecurity incident, and a business continuity and disaster recovery plan. We conduct annual tabletop exercises to test these plans.
•Third-Party Risk Management: We maintain a risk-based approach to identifying and overseeing material cybersecurity threats presented by third parties, including vendors, service providers, as well as the systems of third parties that could adversely impact our business in the event of a material cybersecurity incident affecting those third-party systems, including any outside auditors or consultants who advise on our cybersecurity systems. We collaborate with third parties to assess the effectiveness of our cybersecurity prevention and response systems and processes. These third parties include cybersecurity assessors, consultants and other external cybersecurity experts to assist in the identification, verification, and validation of cybersecurity risks.
•Education and Awareness: We provide quarterly, regular, mandatory training for all employees regarding cybersecurity threats as a means to equip our employees with tools to make employees aware of and to address cybersecurity threats, as well as to communicate our evolving information security policies, standards, processes, and practices.
We conduct quarterly assessments and testing of our policies, standards, processes, and practices in a manner designed to address cybersecurity threats and events. The results of such assessments, audits, and reviews are evaluated by management and reported to the Audit and Finance Committee of the Board, or the Audit and Finance Committee, on a quarterly basis, and we adjust our cybersecurity policies, standards, processes, and practices as necessary based on the information provided by these assessments, audits, and reviews.
Cybersecurity Risk Management Processes Integrated [Flag] true
Cybersecurity Risk Management Processes Integrated [Text Block] Our cybersecurity program is fully integrated into our overall risk management system and processes.
Cybersecurity Risk Management Third Party Engaged [Flag] true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag] false
Cybersecurity Risk Board of Directors Oversight [Text Block]
Governance
The Board, in coordination with the Audit and Finance Committee, oversees our risk management program, including the management of cybersecurity threats. The Board and the Audit and Finance Committee each receive regular presentations and reports on developments in the cybersecurity space, including risk management practices, recent developments, evolving standards, vulnerability assessments, third-party and independent reviews, the threat environment, technological trends, and information security issues encountered by our peers and third parties. The Board and the Audit and Finance Committee also
receive prompt and timely information regarding any cybersecurity risk that meets pre-established reporting thresholds. Annually, the Board and the Audit and Finance Committee discuss our approach to overseeing cybersecurity threats with our Chief Technology Officer, or CTO, and other senior management members.
The CTO, in coordination with senior management including the Chief Executive Officer, Chief Financial Officer, and General Counsel, works collaboratively across our company to implement a program designed to protect our information systems from cybersecurity threats and to promptly respond to any material cybersecurity incidents in accordance with our incident response and recovery plans. To facilitate the success of our cybersecurity program, cross-functional teams have been established to address cybersecurity threats and respond to cybersecurity incidents. Through ongoing communications with these teams, the CTO and senior management are informed about and monitor the prevention, detection, mitigation and remediation of cybersecurity threats and incidents, and report such threats and incidents to the Audit and Finance Committee when appropriate.
The CTO has served in various roles in information technology and information security for over 25 years. The CTO holds undergraduate and graduate degrees in Management Information Systems and Masters in Business Administration. Our Chief Executive Officer, Chief Financial Officer, and General Counsel each hold undergraduate and graduate degrees in their respective fields. Collectively, they have several decades of experience managing risk at our company and in similar organizations or settings and assessing cybersecurity threats.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block] The Board, in coordination with the Audit and Finance Committee, oversees our risk management program, including the management of cybersecurity threats.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block] The Board and the Audit and Finance Committee each receive regular presentations and reports on developments in the cybersecurity space, including risk management practices, recent developments, evolving standards, vulnerability assessments, third-party and independent reviews, the threat environment, technological trends, and information security issues encountered by our peers and third parties. The Board and the Audit and Finance Committee also
receive prompt and timely information regarding any cybersecurity risk that meets pre-established reporting thresholds. Annually, the Board and the Audit and Finance Committee discuss our approach to overseeing cybersecurity threats with our Chief Technology Officer, or CTO, and other senior management members.
Cybersecurity Risk Role of Management [Text Block] The CTO, in coordination with senior management including the Chief Executive Officer, Chief Financial Officer, and General Counsel, works collaboratively across our company to implement a program designed to protect our information systems from cybersecurity threats and to promptly respond to any material cybersecurity incidents in accordance with our incident response and recovery plans
Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block] The CTO, in coordination with senior management including the Chief Executive Officer, Chief Financial Officer, and General Counsel,
Cybersecurity Risk Management Expertise of Management Responsible [Text Block] The CTO has served in various roles in information technology and information security for over 25 years. The CTO holds undergraduate and graduate degrees in Management Information Systems and Masters in Business Administration. Our Chief Executive Officer, Chief Financial Officer, and General Counsel each hold undergraduate and graduate degrees in their respective fields. Collectively, they have several decades of experience managing risk at our company and in similar organizations or settings and assessing cybersecurity threats.
Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block] To facilitate the success of our cybersecurity program, cross-functional teams have been established to address cybersecurity threats and respond to cybersecurity incidents. Through ongoing communications with these teams, the CTO and senior management are informed about and monitor the prevention, detection, mitigation and remediation of cybersecurity threats and incidents, and report such threats and incidents to the Audit and Finance Committee when appropriate.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.4
Summary of Significant Accounting Policies (Policies)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Basis of Presentation
Basis of Presentation
The accompanying consolidated financial statements have been prepared in conformity with accounting principles generally accepted in the United States of America, or U.S. GAAP, and include the accounts of the Company and its subsidiaries. Intercompany transactions have been eliminated.
Certain reclassifications have been made to prior period amounts to conform to current period presentations.
Use of Estimates
Use of Estimates
The preparation of consolidated financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts in the Company's consolidated financial statements and accompanying notes. On an ongoing basis, management evaluates its estimates, including those related to transaction price estimates used for testing services revenue; accrued expenses for clinical studies; inventory valuation; the grant date fair value assumptions used to estimate stock-based compensation expense; income taxes; impairment of long-lived assets and indefinite-lived assets (including goodwill); and legal contingencies. Actual results could differ from those estimates.
Concentrations of Credit Risk and Other Risks and Uncertainties
Concentrations of Credit Risk and Other Risks and Uncertainties
Financial instruments that potentially subject the Company to credit risk consist of cash, cash equivalents and marketable securities. The Company’s policy is to invest its cash and cash equivalents in money market funds, obligations of U.S. government agencies and government-sponsored entities, commercial paper, corporate debt securities and various bank deposit accounts. The counterparties to the agreements relating to the Company’s investments consist of financial institutions of high credit standing. The Company is exposed to credit risk in the event of default by the financial institutions to the extent of amounts recorded on the balance sheets that may be in excess of insured limits.
The Company is also subject to credit risk from its accounts receivable, which are primarily derived from revenue earned from AlloSure Kidney, AlloSure Heart, AlloMap Heart, HeartCare and AlloSure Lung tests provided for patients located in the U.S. and Canada, and billed to various third-party payers, from sales of products to distributors, strategic partners and transplant laboratories in Europe, Asia, the Middle East, Africa, the U.S., Latin America and other geographic regions, and from sales of patient and digital solutions. The Company has not experienced any significant credit losses and does not require collateral on receivables. For the years ended December 31, 2025, 2024 and 2023, approximately 34%, 38% and 40%, respectively, of total revenue was billed to Medicare. No other payers represented more than 10% of total revenue for the years ended December 31, 2025, 2024 and 2023.
As of December 31, 2025 and 2024, approximately 21% and 27%, respectively, of accounts receivable was due from Medicare. No other payer or customer represented more than 10% of accounts receivable at either December 31, 2025 or 2024.
Cash and Cash Equivalents
Cash and Cash Equivalents
Cash equivalents consist of short-term, highly liquid investments with original maturities of three months or less from the date of purchase. Cash equivalents consist primarily of amounts invested in money market funds.
Restricted Cash
Restricted Cash
As a condition of the lease agreements for certain facilities, the Company must maintain letters of credit and certain minimum collateral requirements. The cash used to support these arrangements of $0.6 million is classified as long-term restricted cash on the accompanying consolidated balance sheets.
Marketable Securities
Marketable Securities
The Company considers all highly liquid investments in securities with a maturity of greater than three months at the time of purchase to be marketable securities. As of December 31, 2025, the Company’s marketable securities consisted of corporate debt securities and U.S government securities. Those with maturities of greater than three months but less than 12 months from the balance sheet date were classified as current assets, while investments with maturities of one year or beyond one year from the balance sheet date are classified as non-current assets on the consolidated balance sheet.
The Company classifies its marketable securities as held-to-maturity at the time of purchase and reevaluates such designation at each balance sheet date. The Company has the positive intent and ability to hold these marketable securities to maturity. Marketable securities are carried at amortized cost and are adjusted for amortization of premiums and accretion of discounts to maturity, which is included in interest income, net, on the consolidated statements of operations. Realized gains and losses and declines in value judged to be other-than-temporary, if any, on marketable securities are included in interest income, net. The cost of securities sold is determined using specific identification.
Inventory
Inventory
Inventories are stated at the lower of actual purchased cost, determined on an average cost basis, on a first-in, first-out basis, or at net realizable value. Excess and obsolete inventories are determined primarily based on expiration dates and future demand forecasts, and write-downs of excess and obsolete inventories are recorded as a component of cost of product.
Property and Equipment, net
Property and Equipment, net
Property and equipment are stated at historical cost, less accumulated depreciation. Property and equipment are depreciated using the straight-line method over the estimated useful lives of the assets. The estimated useful life is generally three to five years for computer, office and laboratory equipment, and seven years for furniture and fixtures. Leasehold improvements are amortized over the shorter of their estimated useful lives or the remaining lease term.
The Company capitalizes certain costs incurred for software developed or obtained for internal use, including hosting arrangements. These costs include software licenses and consulting services, as well as employee payroll and payroll-related costs. Capitalized internal-use software costs are usually amortized over a period of three to seven years.
Business Combinations
Business Combinations
The Company determines and allocates the purchase price of an acquired business to the assets acquired and liabilities assumed based on their estimated fair values as of the business combination date, including separately identifiable intangible assets, which are separable from goodwill. The Company bases the estimated fair value of identifiable intangible assets acquired in a business combination on independent valuations that use information and assumptions provided by management, which consider management’s best estimates of inputs and assumptions that a market participant would use. The Company allocates any excess purchase price over the estimated fair value assigned to the net tangible and identifiable intangible assets acquired and liabilities assumed to goodwill. The use of alternative valuation assumptions, including estimated revenue projections, growth rates, royalty rates, cash flows, discount rates, estimated useful lives and probabilities surrounding the achievement of contingent milestones could result in different purchase price allocations and amortization expense in current and future periods.
In those circumstances where an acquisition involves a contingent consideration arrangement that meets the definition of a liability under Accounting Standard Codification, or ASC, Topic 480, Distinguishing Liabilities from Equity, the Company recognizes a liability equal to the fair value of the contingent payments that the Company expects to make as of the acquisition date. The Company remeasures this liability each reporting period and records changes in the fair value as a component of operating expenses.
Transaction costs associated with acquisitions are expensed as incurred in general and administrative expenses. Results of operations and cash flows of acquired companies are included in the Company’s operating results from the date of acquisition.
Acquired Intangible Assets
Acquired Intangible Assets
Amortizable intangible assets include customer relationships, developed technology, commercialization rights, trademarks and tradenames and in-process technology assets acquired as part of a business combination or asset acquisition. Intangible assets subject to amortization are amortized over their estimated useful lives. Acquired in-process technology assets are considered to be indefinite-lived until the completion or abandonment of the associated research and development efforts. If and when development is complete, which generally occurs if and when regulatory approval to market a product is obtained, 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.
Impairment of Goodwill, Intangible Assets and Long-lived Assets
Impairment of Goodwill, Intangible Assets and Long-lived Assets
Goodwill
Goodwill recorded in a business combination is not subject to amortization. Instead, it is tested for impairment on an annual basis and whenever events or changes in circumstances indicate its carrying amount may not be recoverable. The Company has a single reporting unit and consequently evaluates goodwill for impairment based on an evaluation of the fair value of the Company as a whole.
The Company’s annual impairment test date is December 1st. During the goodwill impairment review, the Company assesses qualitative factors to determine whether it is more likely than not that the fair value of the reporting unit is less than the carrying amount, including goodwill. The qualitative factors include, but are not limited to, macroeconomic conditions, industry and the market considerations, and the Company's overall financial performance. If, after assessing the totality of these qualitative factors, the Company determines that it is not more likely than not that the fair value of the reporting unit is less than the carrying amount, then no additional assessment is deemed necessary. Otherwise, the Company proceeds to compare the estimated fair value of the reporting unit with the carrying value, including goodwill. If the carrying amount of the reporting unit exceeds the fair value, the Company records an impairment loss based on the difference.
When necessary, to determine the reporting unit’s fair value under the quantitative approach, the Company uses a combination of income and market approaches, such as estimated discounted future cash flows of that reporting unit, multiples of earnings or revenues, and analysis of recent sales or offerings of comparable entities. The Company also considers its market capitalization on the date of the analysis to assess the reasonableness of the reporting unit’s fair value.
Indefinite-lived intangible assets
The Company evaluates the carrying value of indefinite-lived intangible assets, related to acquired in-process technology assets and a favorable license agreement.
During the period the assets are considered indefinite-lived, they are tested for impairment on an annual basis, as well as between annual tests if the Company becomes aware of any events or changes in circumstances that would indicate that the fair value of the acquired in-process technology assets and the favorable license agreement are less than their carrying amounts. An impairment loss would be recorded when the fair value of an acquired in-process technology asset and the favorable license agreement are less than the carrying value. If and when development is complete, which generally occurs when the products are made commercially available, the associated acquired in-process technology asset and the favorable license agreement will be deemed finite-lived and will then be amortized based on the estimated useful life.
Finite-lived intangible assets and long-lived assets
The Company evaluates its finite-lived intangible assets and its long-lived assets for indicators of possible impairment when events or changes in circumstances indicate that the carrying amount of an asset group may not be recoverable. The Company then compares the carrying amounts of the asset group with the future net undiscounted cash flows expected to be generated by such asset group. If an impairment exists, the Company measures the impairment based on the excess carrying value of the asset group over the asset group’s fair value determined using discounted estimates of future cash flows. Intangible assets subject to amortization are carried at cost less accumulated amortization. Amortization expenses are recorded to cost of testing services, cost of product, cost of patient and digital solutions, research and development expenses and sales and marketing expenses in the consolidated statements of operations.
Fair Value of Financial Instruments
Fair Value of Financial Instruments
Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability (an exit price) in an orderly transaction between market participants at the reporting date. The Company uses the U.S. GAAP fair value hierarchy, which prioritizes the inputs used in the valuation methodologies in measuring fair value as follows:
•Level 1: Inputs that include quoted prices in active markets for identical assets and liabilities.
•Level 2: Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities, quoted prices in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
•Level 3: Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities.
The carrying amounts of certain financial instruments of the Company, including accounts receivable, prepaid expenses and other current assets, accounts payable and accrued liabilities, approximate fair value due to their short maturities. The carrying amount of the contingent consideration liability also represents its fair value.
Leases
Leases
The Company determines if an arrangement is or contains a lease at contract inception. For leases with an initial term of 12 months or more, a right-of-use, or ROU, asset, representing the underlying asset during the lease term, and a lease liability, representing the payment obligation arising from the lease, are recognized on the consolidated balance sheet at lease commencement based on the present value of the payment obligation. For operating leases, expense is recognized on a straight-line basis over the lease term. For finance leases, interest expense on the lease liability is recognized using the effective interest method and amortization of the ROU asset is recognized on a straight-line basis over the shorter of the estimated useful life of the asset or the lease term. The Company also has lease arrangements with lease and non-lease components. The Company does not separate non-lease components from lease components for the Company's facility leases. The Company also elected to apply the short-term lease measurement and recognition exemption in which ROU assets and lease liabilities are not recognized for leases with an initial term of 12 months or less.
The present value of lease payments is determined by using the interest rate implicit in the lease, if that rate is readily determinable; otherwise, the Company uses its incremental borrowing rate. The incremental borrowing rate is determined by using the rate of interest that the Company would pay to borrow on a collateralized basis an amount equal to the lease payments for a similar term and in a similar economic environment.
Revenue
Revenue
The Company recognizes revenue from testing services, product sales, and patient and digital solutions revenue in the amount that reflects the consideration that it expects to be entitled in exchange for goods or services as it transfers control to its customers. Revenue is recorded considering a five-step revenue recognition model that includes identifying the contract with a customer, identifying the performance obligations in the contract, determining the transaction price, allocating the transaction price to the performance obligations, and recognizing revenue when, or as, an entity satisfies a performance obligation.
Testing Services Revenue
AlloSure Kidney, AlloMap Heart, AlloSure Heart, HeartCare and AlloSure Lung patient tests are ordered by healthcare providers. The Company receives a test requisition form with payer information along with a collected patient blood sample. The Company considers the patient to be its customer and the test requisition form to be the contract. Testing services are performed in the Company’s laboratory. Testing services represent one performance obligation in a contract and are performed when results of the test are provided to the healthcare provider, at a point in time.
The healthcare providers that order the tests and on whose behalf the Company provides testing services are generally not responsible for the payment of these services. The first criterion, identify the contracts(s) with a customer, and the second criterion, identify the performance obligations in the contract, of revenue recognition are satisfied when the Company receives a test requisition form with payer information from the healthcare provider. Generally, the Company bills third-party payers upon delivery of an AlloSure Kidney, AlloMap Heart, AlloSure Heart, HeartCare or AlloSure Lung test result to the healthcare provider. Amounts received may vary amongst payers based on coverage practices and policies of the payer. The Company has used the portfolio approach under ASC Topic 606, Revenue from Contracts with Customers, to identify financial classes of payers. Revenue recognized for Medicare and other contracted payers is based on the agreed current reimbursement rate per test, adjusted for historical collection trends where applicable. The Company estimates revenue for non-contracted payers and self-payers using transaction prices determined for each financial class of payers using a history of reimbursements. This includes analysis of the average reimbursement per test and a percentage of tests reimbursed. These estimates require significant judgment.
The Company monitors revenue estimates at each reporting period based on actual cash collections in order to assess whether a revision to the estimate is required. Changes in transaction price estimates are updated quarterly based on actual cash collected or changes made to contracted rates, the Company's discussions with payers, and other pertinent information. In addition,
consistent with ASC 606-10-25-1, the Company continues to assess whether it is probable that it will collect substantially all of the consideration to which it will be entitled when determining if a contract with a customer exists.
For the years ended December 31, 2025 and 2024, the Company recognized $9.6 million and $17.4 million respectively, in revenue for the tests performed in prior periods, as all performance obligations were satisfied at the time the contract was established.
Refunds Reserve

With respect to revenue recognized related to testing services whereby consideration is expected to be received from third-party payers, the Company recognized a constraint to the estimated variable consideration such that it is not probable that a significant revenue reversal will occur. When assessing the total consideration expected to be received from third-party payers, a certain percentage of revenues is further constrained for estimated refunds.
Certain refunds were recognized in accrued liabilities until they are either paid to the respective third-party payers or it is determined the refund will not ultimately be paid, at which time the related accrual is reduced with a corresponding increase to testing services revenue. During the year ended December 31, 2025, the refunds reserve to third-party payers were recognized and testing services revenue decreased by $3.5 million for amounts the Company estimated that would be refunded to third-party payers.

Product Revenue
Product revenue is recognized from the sale of products to end-users, distributors and strategic partners when all revenue recognition criteria are satisfied. The Company generally has a contract or a purchase order from a customer with the specified required terms, including the number of products ordered. Transaction prices are determinable in the contract. The products are delivered and control is transferred to the customer upon either shipping or delivery, as per the terms of the agreement. There are no further performance obligations related to a contract and revenue is recognized at the point of shipment or delivery consistent with the terms of the contract or purchase order.
Patient and Digital Solutions Revenue
Patient and digital solutions revenue is primarily derived from software as a service, or SaaS, agreements entered into with various transplant centers, which are the Company’s customers for this class of revenue. Digital revenue in connection with software license agreements is recognized at the point in time when control of the license is transferred and made available for the customer's use and benefit. The PCS is recognized ratably over the term of the arrangement beginning on the date when access to the subscription is made available to the customer in accordance with ASC 606.
Software license agreements typically require advance payments from customers upon the achievement of certain milestones. The Company records deferred revenue in relation to these agreements when cash payments are received for which the related revenues have not been recognized because one or more of the revenue recognition criteria have not been met, and generally recognizes revenue over the contractual term, as performance obligations are fulfilled.
In addition, the Company derives patient revenue from medication sales. The medication sales revenue is recognized based on the negotiated contract price with the governmental, commercial and non-commercial payers with any applicable patient co-pay. Based on the individual agreement, the Company recognizes revenue from medication sales when prescriptions are shipped or delivered.
Cost of Testing Services
Cost of testing services reflects the aggregate costs incurred in delivering the Company’s testing services. The components of cost of testing services primarily consist of materials and service costs, direct labor costs, stock-based compensation, equipment and infrastructure expenses associated with testing samples, shipping, logistics and specimen processing charges to collect and transport samples, and allocated overhead including rent, information technology, equipment depreciation, utilities and royalties. Royalties for licensed technology, calculated as a percentage of testing services revenues, are recorded as license fees in cost of testing services at the time the testing services revenues are recognized.
Cost of Product
Cost of product reflects the aggregate costs incurred in delivering the Company’s products to customers. The components of cost of product primarily consist of materials costs, manufacturing and kit assembly costs, direct labor costs, equipment and infrastructure expenses associated with preparing kitted products for shipment, shipping, and allocated overhead including rent, information technology, equipment depreciation and utilities. Cost of product also includes amortization of acquired developed technology and adjustments to inventory values, including write-downs of excess or obsolete inventory.
Cost of Patient and Digital Solutions
Cost of patient and digital solutions primarily consists of personnel-related costs associated with developing, installing and maintaining software, depreciation of servers and equipment, amortization of acquired intangible assets, support of the functionality of the software's platforms, including stock-based compensation expenses, cost of medications and allocated costs of facilities and information technology.
Research and Development Expenses
Research and Development Expenses
Research and development expenses, including clinical operations, represent costs incurred to develop diagnostic products and services, high-quality evidence to support the use of the Company’s tests, as well as continued efforts related to improving the Company’s existing products and patient and digital solutions offerings. These expenses include payroll and related expenses, consulting expenses, laboratory supplies, clinical studies and certain allocated expenses as well as amounts incurred under certain collaborative agreements. Research and development costs are expensed as incurred. The Company records accruals for estimated clinical study costs comprised of work performed by contract research organizations based on measure of progress.
Stock-based Compensation
Stock-based Compensation
The Company uses the Black-Scholes Model, which requires the use of estimates such as stock price volatility and expected option lives, to value employee stock options. The Company estimates the expected option lives using historical data, estimates volatility using its own historical stock prices, estimates risk-free rates using the implied yield currently available in the U.S. Treasury zero-coupon issues with a remaining term equal to the expected option lives, and estimates dividend yield using the Company’s expectations and historical data. Compensation expense for stock options issued to nonemployees is calculated using the Black-Scholes Model and is recorded over the service performance period using the straight-line attribution method. Options subject to vesting are required to be periodically remeasured over their service performance period, which is generally the same as the vesting period.
The fair value of each restricted stock unit is calculated based upon the closing price of the Company’s common stock on the date of the grant.
The Company's stock-based compensation arrangements vest over a three to four year vesting schedule. The Company expenses its stock-based compensation under the ratable method, which treats each vesting tranche as if it were an individual grant. Compensation expense is recognized on awards ultimately expected to vest and reduced for forfeitures that are estimated at the time of grant and revised, if necessary, in subsequent periods if actual forfeitures differ from those estimates. Forfeitures are estimated based on the Company's historical experience.
Income Taxes
Income Taxes
The Company accounts for income taxes under the liability method. Under this method, deferred tax assets and liabilities are determined based on the difference between the financial statement and tax bases of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to affect taxable income. Valuation allowances are established when necessary to reduce deferred tax assets to the amounts expected to be realized.
The Company assesses all material positions taken in any income tax return, including all significant uncertain positions, in all tax years that are still subject to assessment or challenge by relevant taxing authorities. The Company’s assessment of an uncertain tax position begins with the initial determination of the position’s sustainability and is measured at the largest amount of benefit that is greater than 50 percent likely of being realized upon ultimate settlement. As of each balance sheet date, unresolved uncertain tax positions must be reassessed, and the Company will determine whether (i) the factors underlying the sustainability assertion have changed and (ii) the amount of the recognized tax benefit is still appropriate. The recognition and measurement of tax benefits requires significant judgment. Judgments concerning the recognition and measurement of a tax benefit may change as new information becomes available.
Foreign Currency Translation
Foreign Currency Translation
The functional currency of the Company’s foreign subsidiaries is the local currency for each entity, including the Swedish Krona and Australian dollar. The revenue and expenses of such subsidiaries have been translated into U.S. dollars at average exchange rates prevailing during the period. Foreign currency translation gains and losses on revenue and expenses are recognized in the consolidated statements of operations. Assets and liabilities have been translated at the rates of exchange on the balance sheet date. The resulting cumulative translation adjustments are reported in other comprehensive income (loss).
Comprehensive Income (Loss)
Comprehensive Income (Loss)
Comprehensive income (loss) consists of net income (loss) and other income and losses affecting stockholders’ equity that, under U.S. GAAP, are excluded from net income or loss. For the Company, such items consist of foreign currency income and losses on the translation of foreign assets and liabilities.
Recent Accounting Pronouncements
Recent Accounting Pronouncements
Adopted in the current period
In December 2023, the FASB issued Accounting Standards Update, or ASU, No. 2023-09, Income Taxes (Topic 340): Improvements to Income Tax Disclosures, which requires annual disclosures in the rate reconciliation table to be presented using both percentages and reporting currency amounts, and this table must include disclosure of specific categories. Additional information is required for reconciling items that meet a quantitative threshold. The new guidance also requires enhanced disclosures of income taxes paid, including the amount of income taxes paid disaggregated by federal, state and foreign taxes and the amount of income taxes paid disaggregated by individual jurisdictions that exceed a quantitative threshold. The Company adopted this ASU on a prospective basis effective January 1, 2025. Refer to Note 12, Income Taxes.
Effective in Future Periods
In December 2025, the Financial Accounting Standards Board, or FASB, issued ASU 2025-11, Narrow-Scope Improvements (Topic 270): Interim Reporting. This update makes targeted, narrow-scope improvements to the interim reporting guidance in Topic 270 to clarify application and improve consistency in practice. The amendments do not change the underlying principles of interim reporting. The amendments in this ASU are effective for interim reporting periods within annual reporting periods beginning after December 15, 2027. Early adoption is permitted. The Company expects to adopt the guidance in its Form 10-Q for the interim period ending March 31, 2028. The Company is currently evaluating the provisions of this ASU and does not expect to have a material impact on its consolidated financial statements.
In December 2025, the FASB issued ASU 2025-12, Codification Improvements, or ASU 2025-12. ASU 2025-12 addresses suggestions received from stakeholders regarding the Accounting Standards Codification and makes other incremental improvements to U.S. GAAP. The update represents changes to the Codification that clarify, correct errors in or make other improvements to a variety of topics that are intended to make it easier to understand and apply. ASU 2025-12 is effective for fiscal years beginning after December 15, 2026 and interim periods within those fiscal years. Entities are required to apply the amendments to ASC 260 retrospectively. Amendments to all other ASC topics may be applied prospectively or retrospectively. Early adoption is permitted. The Company is currently evaluating the provisions of this ASU and does not expect to have a material impact on its consolidated financial statements.
In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures. This standard requires entities to disaggregate certain costs and expenses into specific categories and by relevant expense caption in the statement of operations. This guidance will be effective for the Company's annual disclosures for the fiscal year ending December 31, 2027 and for interim period disclosures beginning in the fiscal year ending December 31, 2028. The Company is currently evaluating the potential impact of the new standard on its consolidated financial statements and related disclosures.
In September 2025, the FASB issued ASU 2025-06, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. This standard modernizes the accounting guidance for internal-use software costs to better reflect current development practices, including agile and iterative methodologies. This guidance is effective for fiscal years beginning after December 15, 2027, including interim periods within those fiscal years. The Company is currently evaluating the provisions of this ASU and does not expect to have a material impact on its consolidated financial statements.
v3.25.4
Net (Loss) Income Per Share (Tables)
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Summary of Computation of Basic and Diluted Net (Loss) Income Per Share
The following tables set forth the computation of the Company’s basic and diluted net (loss) income per share (in thousands, except shares and per share data):
 Year Ended December 31,
 202520242023
Numerator:   
Net (loss) income used to compute basic and diluted net (loss) income per share
$(21,354)$52,549 $(190,284)
Denominator:
Weighted-average shares used to compute basic net (loss) income per share
53,287,546 52,773,247 53,764,705 
Weighted-average shares used to compute diluted net (loss) income per share
53,287,546 56,620,590 53,764,705 
Net (loss) income per share:
Basic$(0.40)$1.00 $(3.54)
Diluted$(0.40)$0.93 $(3.54)
Summary of Potentially Dilutive Securities Excluded from Diluted Net (Loss ) Income Per Share
The following potentially dilutive securities have been excluded from diluted net (loss) income per share because their effect would be antidilutive:
Year Ended December 31,
202520242023
Shares of common stock subject to outstanding options
2,478,871 2,496,063 3,055,208 
Restricted stock units3,930,939 543,479 5,001,370 
Employee stock purchase plan
61,866 66,747 73,759 
Total common stock equivalents6,471,676 3,106,289 8,130,337 
v3.25.4
Fair Value Measurements (Tables)
 12 Months Ended
Dec. 31, 2025
Fair Value Disclosures [Abstract]  
Summary of Fair Value of Financial Assets and Liabilities Measured on Recurring Basis
The following table sets forth the Company’s financial assets and liabilities, measured at fair value on a recurring basis, as of December 31, 2025 and 2024 (in thousands):
December 31, 2025
Fair Value Measured Using
(Level 1)(Level 2)(Level 3)Total Balance
Assets
Cash equivalents:
Money market funds$21,435 $— $— $21,435 
Total$21,435 $— $— $21,435 
Liabilities
Short-term liabilities:
Contingent consideration$— $— $1,617 $1,617 
Long-term liabilities:
Contingent consideration— — 161 161 
Total$— $— $1,778 $1,778 
December 31, 2024
Fair Value Measured Using
(Level 1)(Level 2)(Level 3)Total Balance
Assets
Cash equivalents:
Money market funds$52,230 $— $— $52,230 
Total$52,230 $— $— $52,230 
Liabilities
Short-term liabilities:
Contingent consideration$— $— $2,414 $2,414 
Long-term liabilities:
Contingent consideration— — 174 174 
Total $— $— $2,588 $2,588 
Summary of Issuances, Changes in Fair Value and Reclassifications of Level 3 Financial Instruments
The following table presents the exercise, changes in estimated fair value, additions, deduction and payments of the Company’s Level 3 financial instruments that are measured at fair value on a recurring basis (in thousands):
(Level 3)
Contingent Consideration
Balance at December 31, 2023
$7,930 
Change in estimated fair value of contingent consideration from business combination
931 
Change in estimated fair value of contingent consideration from asset acquisition
(448)
Deduction from contingent consideration
(500)
Payment related to contingent consideration(5,325)
Balance at December 31, 2024
2,588 
Change in estimated fair value of contingent consideration from business combination
704 
Change in estimated fair value of contingent consideration from asset acquisition
(14)
Payment related to contingent consideration(1,500)
Balance at December 31, 2025
$1,778 
v3.25.4
Cash and Marketable Securities (Tables)
 12 Months Ended
Dec. 31, 2025
Cash and Cash Equivalents [Abstract]  
Summary of Cash and Cash Equivalents
A reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the amount reported within the consolidated statements of cash flows is shown in the table below (in thousands):
December 31, 2025December 31, 2024December 31, 2023
Cash and cash equivalents$65,429 $114,689 $82,197 
Restricted cash551 585 586 
Total cash, cash equivalents, and restricted cash at the end of the period$65,980 $115,274 $82,783 
Summary of Restricted Cash
A reconciliation of cash, cash equivalents and restricted cash reported within the consolidated balance sheets to the amount reported within the consolidated statements of cash flows is shown in the table below (in thousands):
December 31, 2025December 31, 2024December 31, 2023
Cash and cash equivalents$65,429 $114,689 $82,197 
Restricted cash551 585 586 
Total cash, cash equivalents, and restricted cash at the end of the period$65,980 $115,274 $82,783 
Summary of Marketable Securities
The amortized cost, unrealized holding gains, and fair value of the Company’s marketable securities by major security type at each balance sheet date are summarized in the tables below (in thousands):
December 31, 2025
Amortized CostUnrealized Holding GainsFair Value
Marketable securities:
U.S. agency securities$81,196 $595$81,791 
Corporate debt securities54,748 5754,805 
Total marketable securities
$135,944 $652$136,596 
December 31, 2024
Amortized Cost
Unrealized Holding Gains
Fair Value
Marketable securities:
U.S. agency securities$90,918 $1,648 $92,566 
Corporate debt securities55,046 718 55,764 
Total marketable securities
$145,964 $2,366 $148,330 
v3.25.4
Goodwill and Intangible Assets (Tables)
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Summary of Intangibles
The following table presents details of the Company’s intangible assets as of December 31, 2025 ($ in thousands):
December 31, 2025
Gross
Carrying
Amount
Accumulated
Amortization
Foreign
Currency
Translation
Net Carrying
Amount
Weighted
Average
Remaining
Useful Life
(In Years)
Intangible assets with finite lives:
Acquired and developed technology$36,517 $(24,127)$(2,203)$10,187 5.8
Customer relationships25,581 (12,413)(1,639)11,529 7.1
Commercialization rights11,579 (7,022)— 4,557 3.6
Trademarks and tradenames4,860 (2,434)(232)2,194 6.6
Total intangible assets with finite lives78,537 (45,996)(4,074)28,467 
Intangible assets with indefinite lives:
Acquired in-process technology1,250 — — 1,250 
Favorable license agreement2,243 — — 2,243 
Total intangible assets with indefinite lives3,493 — — 3,493 
Total intangible assets$82,030 $(45,996)$(4,074)$31,960 
The following table presents details of the Company’s intangible assets as of December 31, 2024 ($ in thousands):
December 31, 2024
Gross
Carrying
Amount
Accumulated
Amortization
Foreign
Currency
Translation
Net Carrying
Amount
Weighted
Average
Remaining
Useful Life
(In Years)
Intangible assets with finite lives:
Acquired and developed technology$37,367 $(21,357)$(2,531)$13,479 6.6
Customer relationships25,718 (10,777)(2,332)12,609 8.4
Commercialization rights11,579 (5,760)— 5,819 4.6
Trademarks and tradenames5,220 (2,094)(356)2,770 8.5
Total intangible assets with finite lives79,884 (39,988)(5,219)34,677 
Acquired in-process technology1,250 — — 1,250 
Favorable license agreement2,257 — — 2,257 
Total intangible assets with indefinite lives3,507 — — 3,507 
Total intangible assets$83,391 $(39,988)$(5,219)$38,184 
Summary of Finite-Lived Intangible Assets Amortization Expense
The following table summarizes the Company's amortization expense of intangible assets (in thousands):
Year Ended December 31,
202520242023
Cost of testing services$1,388 $1,316 $1,316 
Cost of product1,751 1,660 1,655 
Cost of patient and digital solutions610 850 1,039 
Sales and marketing2,602 2,520 2,457 
Total $6,351 $6,346 $6,467 
Summary of Estimated Future Amortization Expense of Intangible Assets
The following table summarizes the Company’s estimated future amortization expense of intangible assets with finite lives as of December 31, 2025 (in thousands):
Years Ending December 31,Total
2026$5,332 
20275,319 
20285,319 
20294,604 
20303,535 
Thereafter4,358 
Total future amortization expense$28,467 
v3.25.4
Balance Sheet Components (Tables)
 12 Months Ended
Dec. 31, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Summary of Inventory
Inventory consisted of the following (in thousands):
December 31,
20252024
Finished goods$9,804 $4,819 
Work in progress3,740 3,793 
Raw materials13,161 10,891 
Total inventory$26,705 $19,503 
Summary of Components of Property and Equipment
Property and equipment consisted of the following (in thousands):
December 31,
20252024
Internally developed software23,016 13,843 
Machinery and equipment$19,110 $18,771 
Leasehold improvements18,171 18,106 
Construction in progress8,280 11,937 
Computer and office equipment1,676 5,650 
Furniture and fixtures1,569 2,187 
Property and equipment71,822 70,494 
Less: Accumulated depreciation and amortization(38,851)(36,942)
Property and equipment, net$32,971 $33,552 
Summary of Components of Accrued and Other Liabilities
Accrued and other liabilities consisted of the following (in thousands):
December 31,
20252024
Clinical studies$12,356 $16,166 
Short-term lease liability6,515 6,103 
Professional fees4,988 5,971 
Deferred revenue4,653 4,848 
Refunds reserve
3,500 — 
Laboratory processing fees and materials2,425 3,184 
Other accrued expenses7,317 7,080 
Total accrued and other liabilities$41,754 $43,352 
v3.25.4
Commitments and Contingencies (Tables)
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
Summary of Lease Cost
The following table summarizes the lease cost for the years ended December 31, (in thousands):
202520242023
Operating lease cost$7,340 $7,717 $7,936 
Total lease cost$7,340 $7,717 $7,936 
December 31,
20252024
Other information:
Weighted-average remaining lease term - Operating leases (in years)4.024.61
Weighted-average discount rate - Operating leases (%)7.0 %7.1 %
Supplemental cash flow information related to leases for the years ended December 31, are as follows (in thousands):
202520242023
Cash paid for amounts included in the measurement of lease liabilities
Operating cash flows used for operating leases$6,055 $5,339 $5,454 
Total$6,055 $5,339 $5,454 
Summary of Maturities of Operating Lease Liabilities
Maturities of operating lease liabilities as of December 31, 2025, are as follows (in thousands):
Years ending December 31,Operating Leases
2026$7,905 
20278,248 
20287,573 
20292,581 
20301,768 
Thereafter1,715 
Total lease payments29,790 
Less imputed interest3,596 
Present value of future minimum lease payments26,194 
Less operating lease liability, current portion6,515 
Operating lease liability, long-term portion$19,679 
v3.25.4
Stock Incentive Plans (Tables)
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Schedule of Common Stock Reserved For Issuance
The Company has reserved common stock, on an if-converted basis, for issuance as follows:
December 31,
20252024
Common stock options outstanding
2,478,871 3,409,912 
RSUs and PSUs outstanding
3,930,939 4,842,670 
Remaining shares reserved for issuance under the 2016 Inducement Equity Incentive Plan, 2019 Inducement Equity Incentive Plan, 2024 Equity Incentive Plan and 2025 Inducement Equity Plan
3,188,940 4,559,101 
Shares reserved under the Employee Stock Purchase Plan
541,706 558,787 
Total
10,140,456 13,370,470 
Summary of Stock Option Activity
The following table summarizes stock option activity during the year ended December 31, 2025:
Number of Shares
Weighted-Average Exercise Price
Stock options outstanding at December 31, 2024
3,409,912 $22.63 
Exercised
(356,383)$16.06 
Forfeited
(91,159)$24.56 
Expired
(483,499)$37.70 
Stock options outstanding at December 31, 2025
2,478,871 $20.47 
Stock options exercisable at December 31, 2025
1,836,376 $22.48 
Summary of Options Outstanding and Exercisable Vested or Expected to Vest
Options outstanding that have vested and are expected to vest at December 31, 2025 are as follows:
Number of
Options Issued
Weighted Average Exercise
Price
Weighted
Average
Remaining
Contractual Life
(Years)
Aggregate
Intrinsic Value
(In thousands)
Vested1,836,376 $22.48 5.77$6,725 
Expected to Vest588,205 14.75 7.864,084 
Total2,424,581 $10,809 
Summary of RSUs Activity
The following table summarizes RSUs and performance restricted stock units, or PSUs, activity during the year ended December 31, 2025:
Number of Shares
Weighted-Average Grant Date Fair Value
RSUs and PSUs outstanding at December 31, 2024
4,842,670 $15.38 
RSUs granted
1,853,239 $18.38 
RSUs vested
(1,765,017)$15.98 
RSUs forfeited
(913,873)$14.35 
PSUs granted
270,405 $18.99 
PSUs vested
(300,318)$15.05 
PSUs forfeited
(56,167)$25.41 
RSUs and PSUs outstanding at December 31, 2025
3,930,939 $15.54 
Summary of PSUs Activity
The following table summarizes RSUs and performance restricted stock units, or PSUs, activity during the year ended December 31, 2025:
Number of Shares
Weighted-Average Grant Date Fair Value
RSUs and PSUs outstanding at December 31, 2024
4,842,670 $15.38 
RSUs granted
1,853,239 $18.38 
RSUs vested
(1,765,017)$15.98 
RSUs forfeited
(913,873)$14.35 
PSUs granted
270,405 $18.99 
PSUs vested
(300,318)$15.05 
PSUs forfeited
(56,167)$25.41 
RSUs and PSUs outstanding at December 31, 2025
3,930,939 $15.54 
Summary of Weighted-Average Assumptions Used to Estimate Fair Value of Share-Based Awards
The estimated fair values of ESPP shares were estimated using the Black-Scholes option pricing model based on the following weighted average assumptions:
Year Ended December 31,
202520242023
Employee stock purchase plan
Expected term (in years)0.50.50.5
Expected volatility
64.40% – 89.52%
69.60% – 91.99%
75.91% – 93.38%
Risk-free interest rate
3.59% – 4.29%
5.24% – 5.37%
5.26% – 5.47%
Expected dividend yield— %— %— %
Summary of Expense Relating to Employee and Nonemployee Stock-Based Payment Awards from Stock Options and RSUs
The following table summarizes stock-based compensation expense relating to employee and non-employee stock-based awards for the years ended December 31, 2025, 2024 and 2023, included on the consolidated statements of operations as follows (in thousands):
Year Ended December 31,
202520242023
Cost of testing services$1,263 $1,560 $1,854 
Cost of product464 870 1,165 
Cost of patient and digital solutions624 1,276 1,377 
Research and development5,043 6,501 6,556 
Sales and marketing8,090 11,035 12,470 
General and administrative19,380 45,164 25,664 
Total$34,864 $66,406 $49,086 
v3.25.4
Income Taxes (Tables)
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Summary of Components of Provision for (Benefit from) Income Taxes
The components of the provision for (benefit from) income taxes are summarized as follows (in thousands):
As of December 31,
202520242023
Pre-tax earnings
Domestic
$(19,128)$55,151 $(188,421)
Foreign
(1,955)(2,292)(1,722)
$(21,083)$52,859 $(190,143)
Current tax expense (benefit)
US federal
$— $2 $(117)
US state & local
420 198 186 
Foreign
— 9 — 
Total current tax expense (benefit)
420 209 69 
Deferred tax expense (benefit)
US federal
$(77)$(10)$184 
US state & local
(11)(26)(112)
Foreign
(61)137 — 
Total deferred tax expense (benefit)
(149)101 72 
Provision for (benefit from) income taxes
$271 $310 $141 
Summary of Provision for Tax Differed from Amounts Computed by Applying the U.S. Federal Income Tax Rate to Loss Before Income
Upon adoption of ASU 2023-09, Improvements to Income Tax Disclosures, as described in Note 2, Summary of Significant Accounting Policies, the Company's actual provision for tax differed from the amounts computed by applying the U.S. federal income tax rate of 21% to pretax income as a result of the following (in thousands, except for percentages):
As of December 31,
2025
Effective tax rate reconciliation
US federal statutory income tax rate
$(4,427)21.0 %
Domestic federal
Tax credits
Research credits(77)0.4 %
Nontaxable and nondeductible items
Non-deductible executive compensation2,217 (10.5)%
Changes in valuation allowances(254)1.2 %
Excess tax benefits on share-based payments(2,115)10.0 %
Other323 (1.5)%
Domestic state and local income taxes, net of federal effect(407)1.9 %
Foreign tax effects350 (1.7)%
Worldwide changes in unrecognized tax benefits4,662 (22.1)%
Total income tax expense (benefit)$271 (1.3)%
The reconciliation of taxes at the federal statutory rate to our provision for (benefit from) income taxes for the years ended December 31, 2024 and 2023 in accordance with the guidance prior to the adoption of ASU 2023-09 was as follows (in millions):
Year ended December 31,
20242023
Federal tax statutory rate21.0 %21.0 %
Stock-based compensation(6.3)%(3.8)%
Change in valuation allowance(18.9)%(18.1)%
Foreign rate differential— %0.2 %
Non-deductible executive compensation9.9 %(0.4)%
Research credits(5.1)%0.4 %
Changes in net operating loss carryforwards, including expirations— %0.8 %
Other— %(0.2)%
Effective income tax rate0.6 %(0.1)%
Summary of Deferred Income Tax Assets and Liabilities
Deferred income tax assets and liabilities consist of the following (in thousands):
As of December 31,
20252024
Deferred tax assets:
Net operating loss carryforwards$34,632 $29,839 
Tax credit carryforwards14,42914,045
Accruals8,3225,027
Lease Liability5,5436,843
Section 174 Capitalized Costs24,38133,651
Stock-based compensation15,79316,163
Other1,1301,061
Total deferred tax assets
104,230106,629
Valuation allowance
(92,636)(92,217)
Deferred tax assets, net of valuation allowance
11,59414,412
Deferred tax liabilities:
Purchased intangibles(3,269)(4,828)
Right-of-Use Asset(4,693)(5,858)
Property and equipment(3,363)(3,524)
Other(450)(366)
Total deferred tax liabilities
(11,775)(14,576)
Net deferred tax asset (liability)
$(181)$(164)
Summary of Reconciliation of Unrecognized Tax Benefits
A reconciliation of the Company's unrecognized tax benefits is as follows (in thousands):
Year ended December 31,
202520242023
Unrecognized tax benefits
Balance, beginning of year
$8,641 $6,184 $5,436 
Increases related to prior year tax positions
4,587 1,134 — 
Decreases related to prior year tax positions
(525)— (91)
Increases related to current year tax positions
776 1,323 839 
Balance, end of year
$13,479 $8,641 $6,184 
Schedule of Income Taxes Paid, Net of Refunds Received
Year ended December 31,
2025
Income taxes paid, net of refunds received
U.S. state & local
284
Total284
v3.25.4
Segment Reporting (Tables)
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Summary of Reportable Revenues by Geographic Regions
Revenue by geographic regions are based upon the customers’ ship-to address for product revenue, the region of testing for testing services revenue and the region where the performance obligation is satisfied for patient and digital solutions revenue. The following table summarizes reportable revenue by geographic regions (in thousands):
Year Ended December 31,
202520242023
Testing services revenue
United States$273,379 $248,247 $209,158 
Rest of World1,116 1,134 527 
$274,495 $249,381 $209,685 
Product revenue
United States$29,908 $26,024 $19,753 
Rest of World18,469 14,759 13,764 
$48,377 $40,783 $33,517 
Patient and digital solutions revenue
United States$56,652 $43,461 $36,719 
Rest of World281 160 403 
$56,933 $43,621 $37,122 
Total revenue
Total United States$359,939 $317,732 $265,630 
Total Rest of World$19,866 $16,053 $14,694 
$379,805 $333,785 $280,324 
Summary of Long-Lived Assets Consisting of Property and Equipment, Net by Geographic Regions
The following table summarizes long-lived assets, consisting of property and equipment, net, by geographic regions (in thousands):
December 31, 2025December 31, 2024
Long-lived assets:
United States$32,635 $33,286 
Rest of World336 266 
Total$32,971 $33,552 
Summary of Reconciliation of Revenue to Net Profit (Loss)
The following table summarizes the reconciliation to net (loss) income (in thousands):
Year Ended December 31,
202520242023
Revenue:
Testing services revenue
$274,495 $249,381 $209,685 
Product revenue
48,377 40,783 33,517 
Patient and digital solutions revenue
56,933 43,621 37,122 
Total revenue
379,805 333,785 280,324 
Less:
Cost of testing services1
59,394 52,734 54,472 
Cost of product1
20,738 20,904 15,672 
Cost of patient and digital solutions1
37,007 28,502 23,631 
Personnel cost131,276 116,251 103,354 
Professional and legal fees
41,973 42,655 63,695 
Research materials and clinical trials expense
10,197 14,653 18,277 
Depreciation and amortization expense
12,033 12,455 12,413 
Stock-based compensation expense
34,864 66,406 49,086 
Litigation settlement expense
5,710 (96,300)96,300 
Transformational initiative costs2
2,824 — — 
Other segment items3
54,317 34,741 45,575 
Interest income, net
(9,174)(11,765)(11,867)
Segment and consolidated net (loss) income
$(21,354)$52,549 $(190,284)
1 Cost of testing services, cost of product and cost of patient and digital solutions include depreciation expense.
2 Transformational initiative costs consist of consulting expenses which relate to the Company's ongoing transformation strategy that the Company has undertaken as a series of initiatives focused on operational excellence, enterprise-wide efficiency, and long-term strategic growth, including rebranding costs.
3 Other segment items include the following: restructuring costs, acquisition costs, software expenses, corporate expenses, rent and maintenance expense, travel and event related expense, one-time impairment charge on intangible asset and associated construction in progress, and other expenses (income).
v3.25.4
Summary of Significant Accounting Policies (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Summary Of Significant Accounting Policies [Line Items]      
Restricted cash $ 551 $ 585 $ 586
Testing services revenue      
Summary Of Significant Accounting Policies [Line Items]      
Revenue recognized 9,600 $ 17,400  
Decrease in revenue $ 3,500    
Furniture and fixtures      
Summary Of Significant Accounting Policies [Line Items]      
Estimated useful lives of assets (in years) 7 years    
Minimum      
Summary Of Significant Accounting Policies [Line Items]      
Vesting period (in years) 3 years    
Minimum | Computer, office and laboratory equipment      
Summary Of Significant Accounting Policies [Line Items]      
Estimated useful lives of assets (in years) 3 years    
Minimum | Internally developed software      
Summary Of Significant Accounting Policies [Line Items]      
Estimated useful lives of assets (in years) 3 years    
Maximum      
Summary Of Significant Accounting Policies [Line Items]      
Vesting period (in years) 4 years    
Maximum | Computer, office and laboratory equipment      
Summary Of Significant Accounting Policies [Line Items]      
Estimated useful lives of assets (in years) 5 years    
Maximum | Internally developed software      
Summary Of Significant Accounting Policies [Line Items]      
Estimated useful lives of assets (in years) 7 years    
Medicare | Services Revenue | Customer Concentration Risk      
Summary Of Significant Accounting Policies [Line Items]      
Concentration risk, percentage (percent) 34.00% 38.00% 40.00%
Medicare | Accounts Receivable | Credit Concentration Risk      
Summary Of Significant Accounting Policies [Line Items]      
Concentration risk, percentage (percent) 21.00% 27.00%  
v3.25.4
Net (Loss) Income Per Share - Summary of Computation of Basic and Diluted Net (Loss) Income Per Share (Details) - USD ($)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Numerator:      
Net (loss) income used to compute basic net (loss) income per share $ (21,354) $ 52,549 $ (190,284)
Net (loss) income used to compute diluted net (loss) income per share $ (21,354) $ 52,549 $ (190,284)
Denominator:      
Weighted-average shares used to compute basic net (loss) income per share (in shares) 53,287,546 52,773,247 53,764,705
Weighted-average shares used to compute diluted net (loss) income per share (in shares) 53,287,546 56,620,590 53,764,705
Net (loss) income per share:      
Basic (in dollars per share) $ (0.40) $ 1.00 $ (3.54)
Diluted (in dollars per share) $ (0.40) $ 0.93 $ (3.54)
v3.25.4
Net (Loss) Income Per Share - Summary of Potentially Dilutive Securities Excluded from Diluted Net (Loss ) Income Per Share (Details) - shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total common stock equivalents (in shares) 6,471,676 3,106,289 8,130,337
Shares of common stock subject to outstanding options      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total common stock equivalents (in shares) 2,478,871 2,496,063 3,055,208
Restricted stock units      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total common stock equivalents (in shares) 3,930,939 543,479 5,001,370
Employee stock purchase plan      
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]      
Total common stock equivalents (in shares) 61,866 66,747 73,759
v3.25.4
Fair Value Measurements - Summary of Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Assets    
Money market funds $ 21,435 $ 52,230
Total 21,435 52,230
Short-term liabilities:    
Contingent consideration 1,617 2,414
Long-term liabilities:    
Contingent consideration 161 174
Total 1,778 2,588
Fair Value Measured Using - (Level 1)    
Assets    
Money market funds 21,435 52,230
Total 21,435 52,230
Short-term liabilities:    
Contingent consideration 0 0
Long-term liabilities:    
Contingent consideration 0 0
Total 0 0
Fair Value Measured Using - (Level 2)    
Assets    
Money market funds 0 0
Total 0 0
Short-term liabilities:    
Contingent consideration 0 0
Long-term liabilities:    
Contingent consideration 0 0
Total 0 0
Fair Value Measured Using - (Level 3)    
Assets    
Money market funds 0 0
Total 0 0
Short-term liabilities:    
Contingent consideration 1,617 2,414
Long-term liabilities:    
Contingent consideration 161 174
Total $ 1,778 $ 2,588
v3.25.4
Fair Value Measurements - Summary of Issuances, Changes in Fair Value and Classifications of Level 3 Financial Instruments (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Contingent Consideration Liability [Member]    
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Beginning balance $ 2,588 $ 7,930
Ending balance 1,778 2,588
Contingent Consideration, Business Combination    
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Change in estimated fair value of common stock warrant liability, contingent consideration on business combinations, and asset acquisition 704 931
Contingent Consideration, Asset Acquisition    
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Change in estimated fair value of common stock warrant liability, contingent consideration on business combinations, and asset acquisition (14) (448)
Contingent Consideration    
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]    
Deduction from contingent consideration   (500)
Payment related to contingent consideration $ (1,500) $ (5,325)
v3.25.4
Fair Value Measurements - Additional Information (Details)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Contingent consideration, measurement input, discount rate (percent) 0.07  
Minimum    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Contingent consideration, measurement input, discount rate (percent)   0.07
Maximum    
Fair Value Measurement Inputs and Valuation Techniques [Line Items]    
Contingent consideration, measurement input, discount rate (percent)   0.12
v3.25.4
Cash and Marketable Securities - Summary of Cash and Cash Equivalents (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash and Cash Equivalents [Abstract]        
Cash and cash equivalents $ 65,429 $ 114,689 $ 82,197  
Restricted cash 551 585 586  
Total cash, cash equivalents, and restricted cash at the end of the period $ 65,980 $ 115,274 $ 82,783 $ 90,443
v3.25.4
Cash and Marketable Securities - Additional Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Cash and Cash Equivalents [Abstract]    
Other than temporary impairment on marketable securities $ 0 $ 0
Marketable securities, non-current $ 24,165 $ 0
v3.25.4
Cash and Marketable Securities - Summary of Components of Marketable Securities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Marketable securities:    
Amortized Cost $ 135,944 $ 145,964
Unrealized Holding Gains 652 2,366
Fair Value 136,596 148,330
U.S. agency securities    
Marketable securities:    
Amortized Cost 81,196 90,918
Unrealized Holding Gains 595 1,648
Fair Value 81,791 92,566
Corporate debt securities    
Marketable securities:    
Amortized Cost 54,748 55,046
Unrealized Holding Gains 57 718
Fair Value $ 54,805 $ 55,764
v3.25.4
Goodwill and Intangible Assets - Additional Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]      
Goodwill impairment $ 0.0 $ 0.0 $ 0.0
Impairment of intangible assets $ 1.7    
Impairment, Intangible Asset, Statement of Income or Comprehensive Income [Extensible Enumeration] Asset impairments and write-downs    
v3.25.4
Goodwill and Intangible Assets - Summary of Intangible Assets (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Intangible assets with finite lives:    
Gross Carrying Amount $ 78,537 $ 79,884
Accumulated Amortization (45,996) (39,988)
Foreign Currency Translation (4,074) (5,219)
Total future amortization expense 28,467 34,677
Intangible assets with indefinite lives:    
Total intangible assets with indefinite lives 3,493 3,507
Total intangible assets    
Total intangible assets - gross carrying amount 82,030 83,391
Total intangible assets, net 31,960 38,184
Acquired in-process technology    
Intangible assets with indefinite lives:    
Total intangible assets with indefinite lives 1,250 1,250
Favorable license agreement    
Intangible assets with indefinite lives:    
Total intangible assets with indefinite lives 2,243 2,257
Acquired and developed technology    
Intangible assets with finite lives:    
Gross Carrying Amount 36,517 37,367
Accumulated Amortization (24,127) (21,357)
Foreign Currency Translation (2,203) (2,531)
Total future amortization expense $ 10,187 $ 13,479
Weighted Average Remaining Useful Life (In Years) 5 years 9 months 18 days 6 years 7 months 6 days
Customer relationships    
Intangible assets with finite lives:    
Gross Carrying Amount $ 25,581 $ 25,718
Accumulated Amortization (12,413) (10,777)
Foreign Currency Translation (1,639) (2,332)
Total future amortization expense $ 11,529 $ 12,609
Weighted Average Remaining Useful Life (In Years) 7 years 1 month 6 days 8 years 4 months 24 days
Commercialization rights    
Intangible assets with finite lives:    
Gross Carrying Amount $ 11,579 $ 11,579
Accumulated Amortization (7,022) (5,760)
Foreign Currency Translation 0 0
Total future amortization expense $ 4,557 $ 5,819
Weighted Average Remaining Useful Life (In Years) 3 years 7 months 6 days 4 years 7 months 6 days
Trademarks and tradenames    
Intangible assets with finite lives:    
Gross Carrying Amount $ 4,860 $ 5,220
Accumulated Amortization (2,434) (2,094)
Foreign Currency Translation (232) (356)
Total future amortization expense $ 2,194 $ 2,770
Weighted Average Remaining Useful Life (In Years) 6 years 7 months 6 days 8 years 6 months
v3.25.4
Goodwill and Intangible Assets - Summary of Finite-Lived Intangible Assets Amortization Expense (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Indefinite-lived Intangible Assets [Line Items]      
Acquisition related-amortization of purchased intangibles $ 6,351 $ 6,346 $ 6,467
Cost of testing services      
Indefinite-lived Intangible Assets [Line Items]      
Acquisition related-amortization of purchased intangibles 1,388 1,316 1,316
Cost of product      
Indefinite-lived Intangible Assets [Line Items]      
Acquisition related-amortization of purchased intangibles 1,751 1,660 1,655
Cost of patient and digital solutions      
Indefinite-lived Intangible Assets [Line Items]      
Acquisition related-amortization of purchased intangibles 610 850 1,039
Sales and marketing      
Indefinite-lived Intangible Assets [Line Items]      
Acquisition related-amortization of purchased intangibles $ 2,602 $ 2,520 $ 2,457
v3.25.4
Goodwill and Intangible Assets - Summary of Estimated Future Amortization Expense of Intangible Assets (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]    
2026 $ 5,332  
2027 5,319  
2028 5,319  
2029 4,604  
2030 3,535  
Thereafter 4,358  
Total future amortization expense $ 28,467 $ 34,677
v3.25.4
Balance Sheet Components - Summary of Inventory (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]    
Finished goods $ 9,804 $ 4,819
Work in progress 3,740 3,793
Raw materials 13,161 10,891
Total inventory $ 26,705 $ 19,503
v3.25.4
Balance Sheet Components - Summary of Components of Property and Equipment (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Property, Plant and Equipment [Line Items]    
Property and equipment $ 71,822 $ 70,494
Less: Accumulated depreciation and amortization (38,851) (36,942)
Property and equipment, net 32,971 33,552
Internally developed software    
Property, Plant and Equipment [Line Items]    
Property and equipment 23,016 13,843
Machinery and equipment    
Property, Plant and Equipment [Line Items]    
Property and equipment 19,110 18,771
Leasehold improvements    
Property, Plant and Equipment [Line Items]    
Property and equipment 18,171 18,106
Construction in progress    
Property, Plant and Equipment [Line Items]    
Property and equipment 8,280 11,937
Computer and office equipment    
Property, Plant and Equipment [Line Items]    
Property and equipment 1,676 5,650
Furniture and fixtures    
Property, Plant and Equipment [Line Items]    
Property and equipment $ 1,569 $ 2,187
v3.25.4
Balance Sheet Components - Additional Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]      
Depreciation expense $ 8.7 $ 7.8 $ 7.9
v3.25.4
Balance Sheet Components - Summary of Components of Accrued Expenses and Other Current Liabilities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]    
Clinical studies $ 12,356 $ 16,166
Short-term lease liability 6,515 6,103
Professional fees 4,988 5,971
Deferred revenue 4,653 4,848
Refunds reserve 3,500 0
Laboratory processing fees and materials 2,425 3,184
Other accrued expenses 7,317 7,080
Total accrued and other liabilities $ 41,754 $ 43,352
v3.25.4
Commitments and Contingencies - Additional Information (Details)
$ in Thousands
 1 Months Ended 12 Months Ended
Apr. 22, 2025
USD ($)
Jan. 26, 2024
USD ($)
May 13, 2022
complaint
Mar. 14, 2022
USD ($)
Jul. 31, 2023
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Dec. 23, 2024
advertisement
Loss Contingencies [Line Items]                
Carrying value of ROU asset           $ 22,760 $ 24,340  
Short-term lease liability           6,515 6,103  
Operating lease liabilities, less current portion           $ 19,679 $ 22,263  
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]           Accrued and other liabilities Accrued and other liabilities  
CAREDX, INC. vs Natera Inc.                
Loss Contingencies [Line Items]                
Litigation settlement       $ 44,900        
Number of claims filed | complaint     2          
Trial duration (in days)   5 days            
Damages awarded   $ 96,300            
Liability for damages awarded             $ 96,300  
Reversal of accrual           $ 96,300    
Range of possible loss (up to)             $ 96,300  
CAREDX, INC. vs Natera Inc. | Compensatory Damages                
Loss Contingencies [Line Items]                
Litigation settlement       21,200        
Number of advertisements with sufficient evidence supporting falsity findings | advertisement               8
CAREDX, INC. vs Natera Inc. | Punitive Damages                
Loss Contingencies [Line Items]                
Litigation settlement       $ 23,700        
Securities Class Action                
Loss Contingencies [Line Items]                
Settlement amount $ 20,250              
iBox License and Collaboration Agreement                
Loss Contingencies [Line Items]                
License period (in years)         4 years      
Minimum                
Loss Contingencies [Line Items]                
Remaining operating lease term (in years)           4 months 28 days    
Maximum                
Loss Contingencies [Line Items]                
Remaining operating lease term (in years)           7 years 1 month 2 days    
v3.25.4
Commitments and Contingencies - Summary of Lease Cost (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]      
Operating lease cost $ 7,340 $ 7,717 $ 7,936
Total lease cost $ 7,340 $ 7,717 $ 7,936
Weighted-average remaining lease term - Operating leases (in years) 4 years 7 days 4 years 7 months 9 days  
Weighted-average discount rate - Operating leases (%) 7.00% 7.10%  
v3.25.4
Commitments and Contingencies - Summary of Noncash Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities      
Operating cash flows used for operating leases $ 6,055 $ 5,339 $ 5,454
Total $ 6,055 $ 5,339 $ 5,454
v3.25.4
Commitments and Contingencies - Summary of Maturities of Operating Lease Liabilities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Operating Leases    
2026 $ 7,905  
2027 8,248  
2028 7,573  
2029 2,581  
2030 1,768  
Thereafter 1,715  
Total lease payments 29,790  
Less imputed interest 3,596  
Present value of future minimum lease payments 26,194  
Less operating lease liability, current portion 6,515 $ 6,103
Operating lease liability, long-term portion $ 19,679 $ 22,263
v3.25.4
Stockholders' Equity (Details)
$ / shares in Units, $ in Millions
 3 Months Ended 12 Months Ended
May 30, 2025
USD ($)
Feb. 20, 2025
USD ($)
Jun. 30, 2025
USD ($)
shares
Dec. 31, 2025
USD ($)
vote
$ / shares
shares
Dec. 31, 2024
$ / shares
shares
May 23, 2024
USD ($)
Share Repurchase Program [Line Items]            
Shares authorized to be issued           $ 250.0
Number of common stock purchased (in shares) | shares       5,800,000    
Stock repurchased value       $ 87.8    
Number of votes entitled per share | vote       1    
Preferred stock, shares authorized (in shares) | shares       10,000,000 10,000,000  
Preferred stock, par value (in dollars per share) | $ / shares       $ 0.001 $ 0.001  
Preferred stock, shares issued (in shares) | shares       0 0  
Preferred stock, shares outstanding (in shares) | shares       0 0  
February 2025 Repurchase Program            
Share Repurchase Program [Line Items]            
Stock repurchase program, authorized amount   $ 50.0        
Stock repurchase program, period in force (in years)   2 years        
Number of common stock purchased (in shares) | shares     3,000,000.0      
Stock repurchased value     $ 50.0      
May 2025 Repurchase Program            
Share Repurchase Program [Line Items]            
Stock repurchase program, authorized amount $ 50.0          
Stock repurchase program, period in force (in years) 2 years          
Number of common stock purchased (in shares) | shares       2,800,000    
Stock repurchased value       $ 37.8    
Stock repurchase program, remaining authorized repurchase amount       $ 12.2    
v3.25.4
401(K) Plan (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Retirement Benefits [Abstract]      
Defined benefit plan, type Postemployment Retirement Benefits [Member]    
Expense incurred related to plan $ 3.8 $ 2.3 $ 1.7
v3.25.4
Stock Incentive Plans - Additional Information (Details) - USD ($)
 12 Months Ended
Jan. 02, 2026
Nov. 04, 2025
Jun. 30, 2025
Jan. 02, 2025
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Apr. 21, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Shares reserved for future issuance of common stock (in shares)         10,140,456 13,370,470    
Options granted (in shares)         0      
Total intrinsic value of options exercised         $ 1,500,000 $ 4,800,000 $ 100,000  
Stock-based compensation expense         34,864,000 66,406,000 49,086,000  
General and administrative                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock-based compensation expense         $ 19,380,000 $ 45,164,000 $ 25,664,000  
Non Employee Director                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Number of shares issued (in shares)         4,794 16,582 21,965  
Non Employee Director | General and administrative                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Stock-based compensation expense         $ 100,000 $ 100,000 $ 200,000  
Restricted stock units                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Total fair value of RSUs vested during the period         31,800,000      
Intrinsic value of RSUs         $ 68,900,000      
Stock options and RSUs and PSUs expected weighted average period (in years)         2 years 1 month 13 days      
Total unrecognized compensation costs related to stock options and RSUs and PSUs         $ 34,800,000      
Performance Shares                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Vesting period (in years)         2 years      
Shares outstanding (in shares)         226,183 335,583    
Stock options and RSUs and PSUs expected weighted average period (in years)         2 years 1 month 2 days 1 year 25 days    
Total unrecognized compensation costs related to stock options and RSUs and PSUs         $ 2,300,000      
Common stock options outstanding                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Shares reserved for future issuance of common stock (in shares)         2,478,871 3,409,912    
Stock options and RSUs and PSUs expected weighted average period (in years)         2 years 1 month 17 days      
Total unrecognized compensation costs related to stock options and RSUs and PSUs         $ 5,500,000      
2025 Inducement Equity Incentive Plan                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Number of shares authorized (in shares)   350,000            
Shares reserved for future issuance of common stock (in shares)         68,745      
2024 Equity Incentive Plan                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Shares reserved for future issuance of common stock (in shares)         3,047,496      
Additional options authorized (in shares)   1,600,000            
2019 Equity Incentive Plan                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Number of shares authorized (in shares)         57,204      
2016 Inducement Plan                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Number of shares authorized (in shares)               155,500
Shares reserved for future issuance of common stock (in shares)         15,495      
2014 Employee Stock Purchase Plan                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Maximum portion of earning an employee may contribute to the ESPP Plan (percent)         15.00%      
Maximum value of shares which an employee can purchase per calendar year         $ 25,000      
Offering period for employee stock purchases         6 months      
Applicable exercise date an offering period shall be equal to percentage of the lower of fair market value of common stock (percent)         85.00%      
Issuance of common stock under employee stock purchase plan (in shares)     84,234 66,747 150,981 159,019    
Proceeds from Issuance of Shares under Incentive and Share-based Compensation Plans, Excluding Stock Options     $ 1,400,000 $ 900,000 $ 2,400,000 $ 1,400,000    
Shares available for issuance (in shares)         541,706      
2014 Employee Stock Purchase Plan | Subsequent Event                
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]                
Issuance of common stock under employee stock purchase plan (in shares) 61,866              
Proceeds from Issuance of Shares under Incentive and Share-based Compensation Plans, Excluding Stock Options $ 1,000,000.0              
v3.25.4
Stock Incentive Plans - Schedule of Common Stock Reserved For Issuance (Details) - shares
Dec. 31, 2025
Dec. 31, 2024
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Total (in shares) 10,140,456 13,370,470
Remaining shares reserved for issuance under the 2016 Inducement Equity Incentive Plan, 2019 Inducement Equity Incentive Plan, 2024 Equity Incentive Plan and 2025 Inducement Equity Plan    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Total (in shares) 3,188,940 4,559,101
Shares reserved under the Employee Stock Purchase Plan    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Total (in shares) 541,706 558,787
Common stock options outstanding    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Total (in shares) 2,478,871 3,409,912
RSUs and PSUs outstanding    
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]    
Total (in shares) 3,930,939 4,842,670
v3.25.4
Stock Incentive Plans - Summary of Stock Option Activity (Details)
 12 Months Ended
Dec. 31, 2025
$ / shares
shares
Number of Shares  
Beginning balance (in shares) | shares 3,409,912
Exercised (in shares) | shares (356,383)
Forfeited (in shares) | shares (91,159)
Expired (in shares) | shares (483,499)
Ending balance (in shares) | shares 2,478,871
Stock options exercisable (in shares) | shares 1,836,376
Weighted-Average Exercise Price  
Beginning balance (in dollars per share) | $ / shares $ 22.63
Exercised (in dollars per share) | $ / shares 16.06
Forfeited (in dollars per share) | $ / shares 24.56
Expired (in dollars per share) | $ / shares 37.70
Ending balance (in dollars per share) | $ / shares 20.47
Stock options exercisable (in dollars per share) | $ / shares $ 22.48
v3.25.4
Stock Incentive Plans - Summary of Options Outstanding Vested and Expected to Vest (Details)
$ / shares in Units, $ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
$ / shares
shares
Share-Based Payment Arrangement [Abstract]  
Vested (in shares) | shares 1,836,376
Expected to vest (in shares) | shares 588,205
Total (in shares) | shares 2,424,581
Vested (in dollars per share) | $ / shares $ 22.48
Expected to vest (in dollars per share) | $ / shares $ 14.75
Vested, weighted average remaining life (years) 5 years 9 months 7 days
Expected to vest, weighted average remaining contractual life (years) 7 years 10 months 9 days
Vested, aggregate intrinsic value | $ $ 6,725
Expected to vest, aggregate intrinsic value | $ 4,084
Aggregate Intrinsic Value, Total | $ $ 10,809
v3.25.4
Stock Incentive Plans - Summary of RSUs and PSUs Activity (Details)
 12 Months Ended
Dec. 31, 2025
$ / shares
shares
RSUs and PSUs outstanding  
Number of Shares  
RSUs and PSUs, beginning balance (in shares) | shares 4,842,670
RSUs and PSUs, ending balance (in shares) | shares 3,930,939
Weighted-Average Grant Date Fair Value  
RSUs and PSUs outstanding, beginning balance (in dollars per share) | $ / shares $ 15.38
RSUs and PSUs outstanding, ending balance (in dollars per share) | $ / shares $ 15.54
Restricted stock units  
Number of Shares  
Granted (in shares) | shares 1,853,239
Vested (in shares) | shares (1,765,017)
Forfeited (in shares) | shares (913,873)
Weighted-Average Grant Date Fair Value  
Granted (in dollars per share) | $ / shares $ 18.38
Vested (in dollars per share) | $ / shares 15.98
Forfeited (in dollars per share) | $ / shares $ 14.35
Performance Shares  
Number of Shares  
Granted (in shares) | shares 270,405
Vested (in shares) | shares (300,318)
Forfeited (in shares) | shares (56,167)
Weighted-Average Grant Date Fair Value  
Granted (in dollars per share) | $ / shares $ 18.99
Vested (in dollars per share) | $ / shares 15.05
Forfeited (in dollars per share) | $ / shares $ 25.41
v3.25.4
Stock Incentive Plans - Summary of Weighted-Average Assumptions Used to Estimated Fair Value of Share-Based Awards (Details) - Employee stock purchase plan
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expected term (in years) 6 months 6 months 6 months
Risk-free interest rate, minimum 3.59% 5.24% 5.26%
Risk-free interest rate, maximum 4.29% 5.37% 5.47%
Expected dividend yield 0.00% 0.00% 0.00%
Minimum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expected volatility 64.40% 69.60% 75.91%
Maximum      
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]      
Expected volatility 89.52% 91.99% 93.38%
v3.25.4
Stock Incentive Plans - Summary of Expense Relating to Employee and Nonemployee Stock-Based Payment Awards from Stock Options and RSUs (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense $ 34,864 $ 66,406 $ 49,086
Cost of Testing Services      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense 1,263 1,560 1,854
Cost of Product      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense 464 870 1,165
Cost of Patient and Digital Solutions      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense 624 1,276 1,377
Research and development      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense 5,043 6,501 6,556
Sales and marketing      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense 8,090 11,035 12,470
General and administrative      
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]      
Stock-based compensation expense $ 19,380 $ 45,164 $ 25,664
v3.25.4
Income Taxes - Summary of Components of Provision for (Benefit from) Income Taxes (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
Domestic $ (19,128) $ 55,151 $ (188,421)
Foreign (1,955) (2,292) (1,722)
(Loss) income before income taxes (21,083) 52,859 (190,143)
Current tax expense (benefit)      
US federal 0 2 (117)
US state & local 420 198 186
Foreign 0 9 0
Total current tax expense (benefit) 420 209 69
Deferred tax expense (benefit)      
US federal (77) (10) 184
US state & local (11) (26) (112)
Foreign (61) 137 0
Total deferred tax expense (benefit) (149) 101 72
Provision for (benefit from) income taxes $ 271 $ 310 $ 141
v3.25.4
Income Taxes - Summary of Provision for Tax Differed from Amounts Computed by Applying U.S. Federal Income Tax Rate to Loss Before Income (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Effective Income Tax Rate Reconciliation, Nondeductible Expense, Depreciation and Amortization, Percent [Abstract]      
US federal statutory income tax rate $ (4,427)    
Tax credits      
Research credits (77)    
Nontaxable and nondeductible items      
Non-deductible executive compensation 2,217    
Changes in valuation allowances (254)    
Excess tax benefits on share-based payments (2,115)    
Other 323    
Domestic state and local income taxes, net of federal effect (407)    
Foreign tax effects 350    
Worldwide changes in unrecognized tax benefits 4,662    
Provision for (benefit from) income taxes $ 271 $ 310 $ 141
Federal tax statutory rate 21.00% 21.00% 21.00%
Tax credits      
Research credits 0.40% (5.10%) 0.40%
Nontaxable and nondeductible items      
Non-deductible executive compensation (10.50%) 9.90% (0.40%)
Change in valuation allowance 1.20% (18.90%) (18.10%)
Excess tax benefits on share-based payments 10.00% (6.30%) (3.80%)
Other (1.50%) 0.00% (0.20%)
Domestic state and local income taxes, net of federal effect 1.90%    
Foreign tax effects (1.70%) 0.00% 0.20%
Worldwide changes in unrecognized tax benefits (22.10%)    
Changes in net operating loss carryforwards, including expirations   0.00% 0.80%
Effective income tax rate (1.30%) 0.60% (0.10%)
v3.25.4
Income Taxes - Summary of Deferred Income Tax Assets and Liabilities (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Deferred tax assets:    
Net operating loss carryforwards $ 34,632 $ 29,839
Tax credit carryforwards 14,429 14,045
Accruals 8,322 5,027
Lease Liability 5,543 6,843
Section 174 Capitalized Costs 24,381 33,651
Stock-based compensation 15,793 16,163
Other 1,130 1,061
Total deferred tax assets 104,230 106,629
Valuation allowance (92,636) (92,217)
Deferred tax assets, net of valuation allowance 11,594 14,412
Deferred tax liabilities:    
Purchased intangibles (3,269) (4,828)
Right-of-Use Asset (4,693) (5,858)
Property and equipment (3,363) (3,524)
Other (450) (366)
Total deferred tax liabilities (11,775) (14,576)
Net deferred tax asset (liability) $ (181) $ (164)
v3.25.4
Income Taxes - Additional Information (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Income Taxes Disclosure [Line Items]        
Increase (decrease) in valuation allowance $ 400 $ (10,600)    
Operating losses that can be carried indefinitely 111,000      
Net unrecognized tax benefit would impact the effective tax rate 0      
Net unrecognized tax benefit 13,479 $ 8,641 $ 6,184 $ 5,436
Interest and penalties incurred during year 200      
Noncurrent Liabilities        
Income Taxes Disclosure [Line Items]        
Interest and penalties incurred during year 200      
Domestic Federal        
Income Taxes Disclosure [Line Items]        
Net operating loss carryforwards 130,800      
Tax credit carryforwards 12,400      
Domestic State        
Income Taxes Disclosure [Line Items]        
Net operating loss carryforwards 6,200      
Domestic State | California        
Income Taxes Disclosure [Line Items]        
Tax credit carryforwards 13,900      
Foreign        
Income Taxes Disclosure [Line Items]        
Net operating loss carryforwards $ 29,300      
Statutes of limitation for income tax returns start year (in years) 4 years      
Statutes of limitation for income tax returns end year (in years) 6 years      
v3.25.4
Income Taxes - Summary of Reconciliation of Unrecognized Tax Benefits (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Unrecognized tax benefits      
Balance, beginning of year $ 8,641 $ 6,184 $ 5,436
Increases related to prior year tax positions 4,587 1,134 0
Decreases related to prior year tax positions (525) 0 (91)
Increases related to current year tax positions 776 1,323 839
Balance, end of year $ 13,479 $ 8,641 $ 6,184
v3.25.4
Income Taxes - Schedule of Income Taxes Paid, Net of Refunds Received (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
Income taxes paid, net of refunds received $ 284 $ 317 $ 738
v3.25.4
Segment Reporting - Additional Information (Details)
 12 Months Ended
Dec. 31, 2025
segment
Segment Reporting [Abstract]  
Number of operating segments 1
Number of reportable segments 1
v3.25.4
Segment Reporting - Summary of Reportable Revenues by Geographic Regions (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Segment Reporting Information [Line Items]      
Total revenue $ 379,805 $ 333,785 $ 280,324
United States      
Segment Reporting Information [Line Items]      
Total revenue 359,939 317,732 265,630
Rest of World      
Segment Reporting Information [Line Items]      
Total revenue 19,866 16,053 14,694
Testing services revenue      
Segment Reporting Information [Line Items]      
Total revenue 274,495 249,381 209,685
Testing services revenue | United States      
Segment Reporting Information [Line Items]      
Total revenue 273,379 248,247 209,158
Testing services revenue | Rest of World      
Segment Reporting Information [Line Items]      
Total revenue 1,116 1,134 527
Product revenue      
Segment Reporting Information [Line Items]      
Total revenue 48,377 40,783 33,517
Product revenue | United States      
Segment Reporting Information [Line Items]      
Total revenue 29,908 26,024 19,753
Product revenue | Rest of World      
Segment Reporting Information [Line Items]      
Total revenue 18,469 14,759 13,764
Patient and digital solutions revenue      
Segment Reporting Information [Line Items]      
Total revenue 56,933 43,621 37,122
Patient and digital solutions revenue | United States      
Segment Reporting Information [Line Items]      
Total revenue 56,652 43,461 36,719
Patient and digital solutions revenue | Rest of World      
Segment Reporting Information [Line Items]      
Total revenue $ 281 $ 160 $ 403
v3.25.4
Segment Reporting - Summary of Long-Lived Assets Consisting of Property and Equipment, Net by Geographic Regions (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Segment Reporting Information [Line Items]    
Long-lived assets $ 32,971 $ 33,552
United States    
Segment Reporting Information [Line Items]    
Long-lived assets 32,635 33,286
Rest of World    
Segment Reporting Information [Line Items]    
Long-lived assets $ 336 $ 266
v3.25.4
Segment Reporting - Summary of Reconciliation of Revenue to Net Profit (Loss) (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue $ 379,805 $ 333,785 $ 280,324
Less:      
Depreciation and amortization 15,018 14,194 14,386
Stock-based compensation expense 34,864 66,406 49,086
Litigation settlement expense 5,710 (96,300) 96,300
Interest income, net (9,174) (11,765) (11,867)
Net (loss) income (21,354) 52,549 (190,284)
Testing services revenue      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 274,495 249,381 209,685
Less:      
Cost of revenue 62,045 55,611 57,642
Product revenue      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 48,377 40,783 33,517
Less:      
Cost of revenue 22,953 23,381 18,379
Patient and digital solutions revenue      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 56,933 43,621 37,122
Less:      
Cost of revenue 38,241 30,704 26,045
Reportable Segment      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 379,805 333,785 280,324
Less:      
Personnel cost 131,276 116,251 103,354
Professional and legal fees 41,973 42,655 63,695
Research materials and clinical trials expense 10,197 14,653 18,277
Depreciation and amortization 12,033 12,455 12,413
Stock-based compensation expense 34,864 66,406 49,086
Litigation settlement expense 5,710 (96,300) 96,300
Transformational initiative costs 2,824 0 0
Other segment items 54,317 34,741 45,575
Interest income, net (9,174) (11,765) (11,867)
Net (loss) income (21,354) 52,549 (190,284)
Reportable Segment | Testing services revenue      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 274,495 249,381 209,685
Less:      
Cost of revenue 59,394 52,734 54,472
Reportable Segment | Product revenue      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 48,377 40,783 33,517
Less:      
Cost of revenue 20,738 20,904 15,672
Reportable Segment | Patient and digital solutions revenue      
Segment, Reconciliation of Other Items from Segments to Consolidated [Line Items]      
Total revenue 56,933 43,621 37,122
Less:      
Cost of revenue $ 37,007 $ 28,502 $ 23,631