7Baggers

Castle Biosciences, Inc
(NASDAQ:CSTL) 

CSTL stock logo

Castle Biosciences, Inc., a commercial-stage dermatological cancer company, focuses to provide diagnostic and prognostic solutions for dermatological cancers. Its lead product is DecisionDx-Melanoma, a multi-gene expression profile (GEP) test to identify high-risk patients with stage I and II melano...

Founded: 2007
IPO Price: $16 (Jul 25, 2019)
Full Time Employees: 133
CEO: Derek J. Maetzold  
Sector: Healthcare
Industry: Diagnostics & Research
Pharmaceuticals
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At a glance:
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Quarterly
Annual
    Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 
                                
      net revenues
    		83,679,000 87,010,000 83,043,000 86,188,000 87,988,000 86,311,000 85,782,000 87,002,000 72,974,000 66,120,000 61,493,000 50,138,000 42,037,000 38,338,000 37,011,000 34,838,000 26,852,000 25,039,000 23,475,000 22,758,000 22,813,000 17,299,000 15,217,000 12,715,000 17,418,000 17,634,553 14,774,891 10,738,569 
      yoy
    		-4.90% 0.81% -3.19% -0.94% 20.57% 30.54% 39.50% 73.53% 73.59% 72.47% 66.15% 43.92% 56.55% 53.11% 57.66% 53.08% 17.70% 44.74% 54.27% 78.99% 30.97% -1.90% 2.99% 18.40%     
      qoq
    		-3.83% 4.78% -3.65% -2.05% 1.94% 0.62% -1.40% 19.22% 10.37% 7.52% 22.65% 19.27% 9.65% 3.59% 6.24% 29.74% 7.24% 6.66% 3.15% -0.24% 31.87% 13.68% 19.68% -27.00% -1.23% 19.35% 37.59%  
      operating expenses
    		                            
      cost of sales
    		20,533,000 18,315,000 18,704,000 17,626,000 16,383,000 16,183,000 15,609,000 14,519,000 13,894,000 12,423,000 11,319,000 11,058,000 10,182,000 9,520,000 8,859,000 7,686,000 5,944,000 4,597,000 4,500,000 3,697,000 3,028,000 2,673,000 2,475,000 2,146,000 2,391,000 2,010,536 1,708,722 1,992,784 
      research and development
    		14,428,000 13,515,000 12,960,000 12,787,000 12,588,000 11,773,000 12,323,000 14,136,000 13,809,000 12,994,000 12,923,000 13,308,000 14,393,000 11,309,000 10,907,000 11,926,000 10,761,000 9,445,000 7,500,000 6,793,000 5,908,000 4,581,000 3,058,000 2,704,000 2,913,000 3,158,946 1,514,966 1,317,237 
      selling, general and administrative
    		64,899,000 56,731,000 55,907,000 58,065,000 58,620,000 49,965,000 50,499,000 51,088,000 48,495,000 44,090,000 44,619,000 44,681,000 46,762,000 38,426,000 36,626,000 37,498,000 30,453,000 25,160,000 22,595,000 20,822,000 18,161,000 14,959,000 11,703,000 10,392,000 11,078,000 9,852,469 7,121,982 6,820,927 
      amortization of acquired intangible assets
    		2,226,000 2,276,000 2,276,000 1,961,000 28,325,000 4,340,000 2,272,000 2,247,000 2,247,000 2,271,000 2,272,000 2,248,000 2,222,000 2,215,000 2,306,000 2,097,000 1,648,000            
      total operating expenses
    		102,086,000 90,837,000 89,847,000 90,439,000 115,916,000 82,261,000 80,703,000 81,990,000 78,445,000 71,778,000 71,133,000 71,295,000 73,559,000 61,170,000 58,547,000 38,809,000 51,368,000 40,210,000 35,289,000 31,568,000 24,069,000 17,658,000 16,643,000 11,214,000 13,991,000 13,011,415 8,636,948 8,138,164 
      operating income
    		-18,407,000 -3,827,000 -6,804,000 -4,251,000 -27,928,000 4,050,000 5,079,000 5,012,000 -5,471,000 -5,658,000 -9,640,000 -21,157,000 -31,522,000 -22,832,000 -21,536,000 -3,971,000 -24,516,000 -15,171,000 -11,814,000 -8,810,000 -4,284,000 -3,032,000 -3,901,000 -645,000 1,036,000 2,612,602 4,429,221 607,621 
      yoy
    		-34.09% -194.49% -233.96% -184.82% 410.47% -171.58% -152.69% -123.69% -82.64% -75.22% -55.24% 432.79% 28.58% 50.50% 82.29% -54.93% 472.27% 400.36% 202.85% 1265.89% -513.51% -216.05% -188.07% -206.15%     
      qoq
    		380.98% -43.75% 60.06% -84.78% -789.58% -20.26% 1.34% -191.61% -3.31% -41.31% -54.44% -32.88% 38.06% 6.02% 442.33% -83.80% 61.60% 28.42% 34.10% 105.65% 41.29% -22.28% 504.81% -162.26% -60.35% -41.01% 628.94%  
      operating margin %
    		-22.00% -4.40% -8.19% -4.93% -31.74% 4.69% 5.92% 5.76% -7.50% -8.56% -15.68% -42.20% -74.99% -59.55% -58.19% -11.40% -91.30% -60.59% -50.33% -38.71% -18.78% -17.53% -25.64% -5.07% 5.95% 14.82% 29.98% 5.66% 
      interest income
    		2,545,000 2,896,000 2,833,000 2,944,000 3,099,000 3,372,000 3,404,000 3,144,000 2,996,000 1,876,000 2,769,000 2,399,000 2,336,000 2,275,000 1,293,000 370,000 30,000 17,000 23,000 24,000 4,000 19,000 18,000 38,000 298,000 280,492 5,190 5,529 
      net gains on equity securities
    		2,022,000                            
      interest expense
    		-134,000 -24,000 -24,000 -21,000 -17,000 -92,000 -201,000 -270,000 -14,000 -2,000 -2,000 -3,000 -4,000 -4,000 -6,000 -4,000 -3,000     -395,000 -706,000 -769,000 -764,000 -765,888 -1,088,130 -1,692,582 
      other loss
    		-439,000                            
      income before income taxes
    		-14,413,000 -2,714,000 -386,000 -143,000 -26,271,000 7,885,000 8,282,000 7,886,000 -2,489,000 -2,541,000 -6,873,000 -18,761,000 -29,190,000 -20,561,000 -20,249,000 -3,605,000 -24,489,000 -15,155,000 -11,791,000 -8,786,000 -4,280,000 -4,805,000 -4,589,000 -1,376,000 570,000 2,126,767 5,849,295 -1,269,079 
      income tax expense
    		109,000 -382,000 115,000  -423,000 -1,705,000 6,013,000 -1,034,000 45,000 39,000 32,000 16,000 14,000 -455,750  -1,957,000 134,000 -8,725,000  5,000         
      net income
    		-14,522,000 -2,332,000 -501,000 4,523,000 -25,848,000 9,590,000 2,269,000 8,920,000 -2,534,000 -2,580,000 -6,905,000 -18,777,000 -29,204,000 -20,618,000 -20,249,000      -4,280,000 -4,889,000 -4,589,000  570,000 2,054,767 5,849,295  
      yoy
    		-43.82% -124.32% -122.08% -49.29% 920.05% -471.71% -132.86% -147.50% -91.32% -87.49% -65.90%          -850.88% -337.93% -178.45%      
      qoq
    		522.73% 365.47% -111.08% -117.50% -369.53% 322.65% -74.56% -452.01% -1.78% -62.64% -63.23% -35.70% 41.64% 1.82%       -12.46% 6.54%   -72.26% -64.87%   
      net income margin %
    		-17.35% -2.68% -0.60% 5.25% -29.38% 11.11% 2.65% 10.25% -3.47% -3.90% -11.23% -37.45% -69.47% -53.78% -54.71% 0% 0% 0% 0% 0% -18.76% -28.26% -30.16% 0% 3.27% 11.65% 39.59% 0% 
      loss per share, basic and diluted
    		-0.49    -0.9    -0.09 -0.09 -0.26 -0.7 -1.1 -0.79 -0.77 -0.06 -0.97            
      weighted-average shares outstanding, basic and diluted
    		29,889    28,609    27,485 26,802 26,834 26,733 26,607 26,054 26,316 26,064 25,424           2,152,965 
      changes in fair value of equity securities
    		 830,250 3,561,000                          
      other expense
    		 12,000 48,000                       -8 -2,710,417  
      earnings per share:
    		                            
      basic
    		 -0.07 -0.02 0.16  0.35 0.08 0.32             -0.17 -0.25 -0.23  0.03 0.18 0.43  
      diluted
    		 -0.07 -0.02 0.15  0.32 0.08 0.31             -0.17 -0.25 -0.23  0.03 0.46 0.05  
      weighted-average shares outstanding:
    		63,146,000 68,695,000 64,339,000 68,562,000 71,605,000 70,128,000 70,173,000 72,483,000 59,080,000 53,697,000 50,174,000 39,080,000 31,855,000 28,818,000 28,152,000 27,152,000 20,908,000 20,442,000 18,975,000 19,061,000 19,785,000 14,626,000 12,742,000 10,569,000 15,027,000 15,624,017 13,066,169 8,745,785 
      yoy
    		-11.81% -2.04% -8.31% -5.41% 21.20% 30.60% 39.86% 85.47% 85.47% 86.33% 78.23% 43.93% 52.36% 40.97% 48.36% 42.45% 5.68% 39.76% 48.92% 80.35% 31.66% -6.39% -2.48% 20.85%     
      qoq
    		-8.08% 6.77% -6.16% -4.25% 2.11% -0.06% -3.19% 22.69% 10.02% 7.02% 28.39% 22.68% 10.54% 2.37% 3.68% 29.86% 2.28% 7.73% -0.45% -3.66% 35.27% 14.79% 20.56% -29.67% -3.82% 19.58% 49.40%  
      gross margin %
    		75.46% 78.95% 77.48% 79.55% 81.38% 81.25% 81.80% 83.31% 80.96% 81.21% 81.59% 77.94% 75.78% 75.17% 76.06% 77.94% 77.86% 81.64% 80.83% 83.76% 86.73% 84.55% 83.74% 83.12% 86.27% 88.60% 88.43% 81.44% 
      basic
    		 28,986 29,073 28,914  27,776 27,840 27,646          25,137 25,287 25,091 24,912 18,929 19,936 17,544 17,372 8,584 12,757,658  
      diluted
    		 28,986 29,073 29,545  29,255 29,401 28,738          25,137 25,287 25,091 24,912 18,929 19,936 17,544 18,734 8,658 14,301,663  
      changes in fair value of trading securities
    		   1,185,000 -1,425,000                        
      income tax benefit
    		   -4,666,000                         
      operating expenses and other operating income
    		                            
      change in fair value of contingent consideration
    		             -300,000 -151,000 -20,398,000 2,562,000            
      net loss and comprehensive loss
    		               -1,648,000 -24,623,000 -6,430,000 -11,791,000 -8,791,000    -1,376,000    -1,269,079 
      operating expenses and other operating loss
    		                            
      amortization of acquired intangible asset
    		                 237,500 694,000 256,000         
      other operating loss
    		                      1,882,000      
      loss per share:
    		                            
      basic
    		                 -0.248 -0.47 -0.35         
      diluted
    		                 -0.248 -0.47 -0.35         
      other operating income
    		                       -1,882,000     
      gross margin
    		                    19,785,000 14,626,000 12,742,000 10,569,000 15,027,000 15,624,017 13,066,169 8,745,785 
      gain on extinguishment of debt
    		                         -431 5,213,431  
      convertible preferred stock cumulative dividends
    		                         -358 288,891 938,892 
      accretion of redeemable convertible preferred stock to redemption value
    		                         -151 17,578 56,775 
      net income and comprehensive income attributable to common stockholders
    		                     -4,889,000 -4,589,000  570,000 2,055,276 5,542,826  
      earnings per share attributable to common stockholders:
    		                            
      basic
    		 -0.07 -0.02 0.16  0.35 0.08 0.32             -0.17 -0.25 -0.23  0.03 0.18 0.43  
      diluted
    		 -0.07 -0.02 0.15  0.32 0.08 0.31             -0.17 -0.25 -0.23  0.03 0.46 0.05  
      net loss and comprehensive loss attributable to common stockholders
    		                       -1,376,000    -2,264,746 
      loss per share attributable to common stockholders:
    		                            
      basic
    		                       -0.08     
      diluted
    		                       -0.08     
      other income
    		                           -189,647 
      loss per share attributable to common stockholders, basic and diluted
    		                           -1.05 
    Balance Sheets:
    Quarterly
    Annual
      Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 
                                  
        assets
      		                            
        current assets
      		                            
        cash and cash equivalents
      		63,764,000 116,729,000 85,556,000 82,233,000 89,689,000 119,709,000 94,959,000 85,572,000 82,949,000 98,841,000 91,223,000 95,874,000 114,821,000 122,948,000 134,180,000 273,166,000 309,017,000 329,633,000 363,177,000 368,339,000 406,981,000 409,852,000 183,050,000 179,759,000 98,653,000 98,845,000 94,474,818 17,468,466 
        marketable investment securities
      		197,921,000 182,776,000 201,986,000 193,697,000 185,462,000 173,421,000 184,826,000 174,116,000 156,264,000 144,258,000 138,530,000 129,634,000 117,234,000 135,677,000 131,802,000              
        accounts receivable
      		42,264,000 43,382,000 49,482,000 52,311,000 56,353,000 51,218,000 50,261,000 45,988,000 42,699,000 38,302,000 37,003,000 31,314,000 27,728,000 23,476,000 22,835,000 22,606,000 19,910,000 17,282,000 18,532,000 17,817,000 14,292,000 12,759,000 12,618,000 12,528,000 14,600,000 14,648,000 12,369,260 9,730,319 
        inventory
      		10,461,000 10,254,000 8,650,000 8,366,000 6,849,000 8,135,000 6,572,000 8,013,000 7,645,000 7,942,000 5,769,000 6,121,000 4,520,000 3,980,000 3,802,000 3,365,000 2,350,000 2,021,000 2,375,000 2,124,000 2,310,000 2,217,000 1,679,000 1,667,000 1,219,000 1,237,000 821,658 550,894 
        prepaid expenses and other current assets
      		14,491,000 7,956,000 11,895,000 12,061,000 11,035,000 7,671,000 8,154,000 6,716,000 6,221,000 6,292,000 7,097,000 6,111,000 6,797,000 6,207,000 6,795,000 5,775,000 5,164,000 4,807,000 5,500,000 3,419,000 3,087,000 4,766,000 3,718,000 1,717,000 2,080,000 1,951,000 2,197,235 774,885 
        total current assets
      		328,901,000 361,097,000 357,569,000 348,668,000 349,388,000 360,154,000 344,772,000 320,405,000 295,778,000 295,635,000 279,622,000 269,054,000 271,100,000 292,288,000 299,414,000 304,912,000 336,441,000 353,743,000 389,584,000 391,699,000 426,670,000 429,594,000 201,065,000 195,671,000 116,552,000 116,681,000 109,862,971 28,524,564 
        long-term accounts receivable
      		1,921,000 1,878,000 2,050,000 1,132,000 1,000,000 918,000 1,106,000 1,125,000 1,056,000 1,191,000 1,338,000 1,227,000 1,218,000 1,087,000 1,187,000 1,367,000 1,406,000 1,308,000 1,410,000 1,313,000 1,121,000 1,096,000 1,045,000 652,000 756,000 870,000 1,451,872 1,266,098 
        property and equipment
      		100,934,000 97,443,000 84,885,000 74,060,000 55,423,000 51,122,000 44,383,000 38,638,000 32,904,000 25,433,000 22,273,000 20,511,000 18,254,000 14,315,000 13,054,000 11,203,000 9,385,000 9,501,000 8,866,000 8,092,000 7,780,000 7,102,000 6,646,000 5,024,000 2,733,000 2,060,000 1,798,236 1,743,170 
        operating lease assets
      		14,424,000 14,795,000 15,151,000 15,503,000 11,164,000 11,584,000 11,904,000 11,621,000 11,961,000 12,306,000 11,613,000 11,539,000 11,401,000 12,181,000 12,604,000 7,004,000 7,219,000 7,383,000           
        goodwill and other intangible assets
      		97,347,000 99,574,000 101,849,000 104,125,000 77,904,000 106,229,000 110,569,000 112,840,000 115,088,000 117,335,000 119,607,000 121,879,000 124,126,000 126,348,000 130,357,000 132,671,000             
        other assets – long-term
      		4,278,000 3,769,000 1,282,000 1,241,000 1,266,000 1,228,000 1,831,000 2,683,000 1,720,000 1,440,000 1,566,000 1,190,000 792,000 1,110,000 1,195,000 1,223,000 2,699,000 1,715,000 1,728,000 1,631,000 1,761,000 1,536,000 1,638,000 199,000 216,000 135,000 87,168 1,813,311 
        total assets
      		547,805,000 578,556,000 562,786,000 544,729,000 501,715,000 531,235,000 514,565,000 487,312,000 458,507,000 453,340,000 436,019,000 425,400,000 426,891,000 447,329,000 457,811,000 458,380,000 444,425,000 462,572,000 433,692,000 435,533,000 437,332,000 439,328,000 210,394,000 201,546,000 120,257,000 119,746,000 113,200,247 33,347,143 
        liabilities and stockholders’ equity
      		                            
        current liabilities
      		                            
        accounts payable
      		15,038,000 18,711,000 12,211,000 13,181,000 8,502,000 6,901,000 6,810,000 9,540,000 9,318,000 10,268,000 6,929,000 7,135,000 9,961,000 4,731,000 5,768,000 3,281,000 3,314,000 2,546,000 2,766,000 1,368,000 2,172,000 2,098,000 2,101,000 2,495,000 1,934,000 1,865,000 1,251,267 2,084,910 
        accrued compensation
      		19,111,000 38,287,000 31,763,000 24,973,000 17,857,000 32,555,000 27,672,000 21,239,000 14,708,000 28,945,000 22,405,000 17,298,000 12,796,000 24,358,000 19,532,000 14,850,000 8,566,000 15,483,000 12,120,000 8,584,000 5,208,000 9,108,000 6,354,000 4,651,000 3,134,000 5,779,000 3,676,164 2,784,746 
        contingent consideration
      		1,000,000 1,000,000 1,000,000 1,000,000             20,849,000 18,287,000           
        operating lease liabilities
      		1,254,000 1,325,000 1,449,000 1,571,000 1,435,000 1,665,000 1,745,000 1,226,000 1,189,000 1,137,000 1,091,000 1,966,000 1,779,000 1,777,000 1,535,000 1,211,000 1,199,000 1,179,000           
        current portion of long-term debt
      		1,667,000 417,000  1,944,000 1,111,000 278,000                 10,000,000 10,000,000 8,333,000 5,833,000 3,333,333 833,333 
        other accrued and current liabilities
      		10,691,000 8,937,000 8,885,000 8,221,000 8,369,000 7,993,000 8,068,000 7,449,000 6,744,000 7,317,000 5,899,000 7,318,000 5,607,000 5,262,000 5,107,000 8,177,000 5,593,000 5,678,000           
        total current liabilities
      		48,761,000 68,677,000 55,308,000 50,890,000 37,274,000 49,392,000 44,295,000 39,454,000 31,959,000 47,667,000 36,324,000 33,717,000 30,143,000 36,128,000 31,942,000 27,519,000 39,521,000 24,886,000 20,993,000 18,654,000 17,578,000 20,876,000 30,240,000 28,242,000 15,256,000 15,289,000 9,237,741 11,745,674 
        long-term debt
      		8,399,000 9,640,000 10,049,000 8,096,000 8,921,000 9,745,000 10,015,000 10,008,000 10,000,000              12,455,000 14,741,000 17,013,000 19,289,000 21,570,372 23,858,781 
        noncurrent portion of contingent consideration
      		1,500,000 1,500,000 1,500,000 1,500,000           1,798,000 1,949,000             
        noncurrent operating lease liabilities
      		25,116,000 25,217,000 25,302,000 25,377,000 14,049,000 14,345,000 14,691,000 13,645,000 13,864,000 14,173,000 13,435,000 12,427,000 11,103,000 11,533,000 11,900,000 6,480,000 6,711,000 6,900,000           
        noncurrent finance lease liabilities
      		288,000 314,000 339,000 364,000 328,000 311,000 289,000 312,000                     
        deferred tax liability
      		2,325,000 2,335,000 3,242,000 3,126,000 837,000 1,607,000 4,220,000  206,000 206,000 441,000 441,000 441,000 428,000 614,000 614,000 757,000 635,000           
        total liabilities
      		86,389,000 107,683,000 95,740,000 89,353,000 61,409,000 75,400,000 73,510,000 63,419,000 56,045,000 62,071,000 50,236,000 46,632,000 41,742,000 48,179,000 46,378,000 36,720,000 47,089,000 50,832,000 21,979,000 19,617,000 18,745,000 23,637,000 43,835,000 43,924,000 32,323,000 34,633,000 30,864,119 36,940,985 
        commitments and contingencies
      		                            
        stockholders’ equity
      		                            
        preferred stock, 0.001 par value per share...
      		                            
        common stock, 0.001 par value per share...
      		30,000 30,000 29,000 29,000 29,000  28,000 28,000 28,000  27,000 27,000 27,000  26,000 26,000 25,000            
        additional paid-in capital
      		700,255,000 694,860,000 688,729,000 676,759,000 666,120,000 655,703,000 650,270,000 636,022,000 623,450,000 609,477,000 601,618,000 587,771,000 575,367,000 560,409,000 551,883,000 541,672,000 515,701,000 505,482,000 499,046,000 491,458,000 485,338,000 478,162,000 224,146,000 210,621,000 139,559,000 137,308,000 136,585,399 9,910,882 
        accumulated deficit
      		-238,806,000 -224,284,000 -221,952,000 -221,451,000 -225,974,000 -200,126,000 -209,716,000 -211,985,000 -220,905,000 -218,371,000 -215,791,000 -208,886,000 -190,109,000 -160,905,000 -140,287,000 -120,038,000 -118,390,000 -93,767,000 -87,358,000 -75,567,000 -66,776,000 -62,496,000 -57,607,000 -53,018,000 -51,642,000 -52,212,000 -54,266,345 -60,115,640 
        accumulated other comprehensive income
      		-63,000 267,000 240,000 39,000 131,000 230,000 473,000 -172,000 -111,000 136,000                   
        total stockholders’ equity
      		461,416,000 470,873,000 467,046,000 455,376,000 440,306,000 455,835,000 441,055,000 423,893,000 402,462,000 391,269,000 385,783,000 378,768,000 385,149,000 399,150,000 411,433,000 421,660,000 397,336,000 411,740,000 411,713,000 415,916,000 418,587,000 415,691,000 166,559,000 157,622,000 87,934,000 85,113,000 82,336,128  
        total liabilities and stockholders’ equity
      		547,805,000 578,556,000 562,786,000 544,729,000 501,715,000 531,235,000 514,565,000 487,312,000 458,507,000 453,340,000 436,019,000 425,400,000 426,891,000 447,329,000 457,811,000 458,380,000 444,425,000 462,572,000 433,692,000 435,533,000 437,332,000 439,328,000 210,394,000 201,546,000 120,257,000    
        long-term marketable investment securities
      		    5,570,000                        
        preferred stock, 0.001 par value...
      		                            
        common stock, 0.001 par value...
      		     28,000    27,000    27,000    25,000 25,000 25,000 25,000 25,000 20,000 19,000 17,000 17,000 17,074 2,192 
        other liabilities
      		        16,000 25,000 36,000 47,000 55,000 90,000 124,000 158,000 100,000 124,000           
        accumulated other comprehensive loss
      		          -71,000 -144,000 -136,000 -381,000 -189,000              
        intangible assets
      		                87,275,000 88,922,000           
        medicare advance payment
      		                  2,999,000 6,177,000 8,178,000 6,615,000 8,350,000 8,350,000     
        noncurrent portion of medicare advance payment
      		                    172,000 1,735,000       
        intangible asset
      		                  32,104,000 32,798,000         
        other accrued liabilities
      		                  3,108,000 2,525,000 2,020,000 3,055,000 3,435,000 2,746,000 1,855,000 1,812,000 976,977 1,616,866 
        deferred rent and other liabilities
      		                  986,000 963,000 995,000 1,026,000 1,140,000 941,000     
        deferred rent liability
      		                        54,000 55,000 56,006 56,690 
        liabilities, convertible preferred stock and stockholders’ equity
      		                            
        preferred stock warrant liability
      		                           1,279,840 
        convertible preferred stock
      		                            
        convertible preferred stock series c, 0.001 par value...
      		                           1,500,994 
        redeemable convertible preferred stock series a, b, d, e-1, e-2, e-2a, e-3 and f, 0.001 par value...
      		                           45,107,730 
        total liabilities, convertible preferred stock and stockholders’ equity
      		                         119,746,000 113,200,247  
        liabilities, convertible preferred stock and stockholders’ deficit
      		                            
        convertible promissory notes
      		                           4,425,819 
        stockholders’ deficit
      		                            
        total stockholders’ deficit
      		                           -50,202,566 
        total liabilities, convertible preferred stock and stockholders’ deficit
      		                           33,347,143 
      Cashflow Statements:
      Quarterly
      Annual
        Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 
                                   
          operating activities
        		                           
          net loss
        		-14,522,000    -25,848,000    -2,534,000 -2,580,000 -6,905,000 -18,777,000 -29,204,000 -20,618,000 -20,249,000 -1,648,000 -24,623,000 -6,430,000 -11,791,000         
          adjustments to reconcile net loss to net cash from operating activities:
        		                           
          depreciation and amortization
        		3,929,000 3,777,000 3,816,000 3,414,000 29,764,000 5,768,000 3,541,000 3,348,000 3,340,000 3,224,000 3,174,000 3,040,000 2,892,000 2,841,000 2,923,000 2,628,000 2,151,000 1,451,000 1,089,000         
          stock-based compensation expense
        		9,776,000 11,406,000 12,100,000 11,208,000 11,179,000 11,439,000 13,027,000 13,179,000 12,675,000 11,802,000 13,043,000 12,849,000 13,525,000 9,923,000 9,196,000 8,783,000 8,419,000           
          net losses on equity securities
        		-2,022,000                           
          deferred income taxes
        		-10,000 -907,000 116,000 -4,667,000 -770,000 -2,307,000 5,250,000   -236,000 0 0 13,000 -38,000 0 -1,962,000 123,000           
          accretion of discounts on marketable investment securities
        		-454,000 -708,000 -905,000 -1,171,000 -1,435,000 -1,613,000 -1,650,000 -1,723,000 -1,699,000 -1,640,000 -1,569,000 -1,053,000 -1,229,000 -1,184,000              
          other
        		532,000 -129,000 63,000 189,000 30,000 60,000 125,000 -96,000 179,000 351,000 71,000 2,000 211,000 -28,000 147,000 27,000 12,000  -168,000 36,000 33,000 -19,000     0 
          change in operating assets and liabilities:
        		                           
          accounts receivable
        		1,075,000 6,272,000 1,911,000 3,910,000 -5,217,000 -769,000 -4,254,000 -3,358,000 -4,262,000 -1,151,000 -5,801,000 -3,595,000 -4,383,000 -540,000 -50,000 -2,903,000 -2,725,000 1,456,000 -812,000 -3,717,000 -1,558,000 -192,000 -482,000 2,176,000 161,000 -1,696,598 -2,824,715 
          prepaid expenses and other current assets
        		-6,667,000 3,991,000 161,000 -1,332,000 -3,364,000 537,000 -1,385,000 -191,000 -103,000 457,000 -1,050,000 812,000 -654,000 646,000 -1,163,000 -350,000 -357,000 1,351,000 -2,081,000 -332,000 1,679,000 -1,048,000 -2,001,000 363,000 -129,000 245,673 -1,422,350 
          inventory
        		-207,000 -1,604,000 -307,000 -1,517,000 1,286,000 -1,563,000 1,441,000 -368,000 297,000 -2,173,000 352,000 -1,601,000 -540,000 -178,000 -436,000 -737,000 -329,000 355,000 -251,000 316,000 -93,000 -538,000 -12,000 -449,000 19,000 -415,575 -270,764 
          operating lease assets
        		371,000 356,000 352,000 244,000 420,000 320,000 324,000 340,000 338,000 332,000 -121,000 -800,000 331,000 297,000 257,000 215,000 222,000           
          other assets
        		-530,000 -312,000 -41,000 25,000 -38,000 297,000 -178,000 373,000 -230,000 125,000 -375,000 -399,000 319,000 85,000 29,000 462,000 42,000 13,000 -98,000 130,000 -225,000 102,000 -1,441,000 15,000 -77,000 -64,744 -8,199 
          accounts payable
        		3,193,000 -17,000 1,406,000 1,074,000 615,000 -570,000 -2,152,000 -1,228,000 -422,000 3,014,000 -378,000 -825,000 3,896,000 -1,573,000 1,853,000 115,000 187,000 -855,000 1,356,000 -643,000 -40,000 -42,000 -233,000 388,000 56,000 603,932 477,097 
          operating lease liabilities
        		-172,000 -209,000 -197,000 -343,000 -526,000 -426,000 -431,000 -182,000 -250,000 -241,000 135,000 1,026,000 -68,000 -49,000 -114,000 -219,000 -226,000           
          accrued compensation
        		-19,176,000 6,524,000 6,790,000 7,116,000 -14,698,000 4,883,000 6,433,000 6,531,000 -14,237,000 6,540,000 5,107,000 4,502,000 -11,562,000 4,826,000 4,682,000 5,904,000 -6,917,000 3,196,000 3,535,000 3,376,000 -3,899,000 2,754,000 1,702,000 1,518,000 -2,645,000 2,102,847 891,418 
          other accrued and current liabilities
        		2,755,000 -1,032,000 1,428,000 -667,000 1,141,000 -726,000 978,000 -5,000 73,000 763,000 -671,000 1,033,000 1,014,000               
          net cash from operating activities
        		-22,129,000 26,931,000 22,631,000 20,821,000 -6,036,000 24,365,000 23,338,000 23,998,000 -6,835,000 18,587,000 5,012,000 -3,786,000 -25,439,000 -6,000,000 -5,224,000 -9,001,000 -21,430,000 -2,781,000 -6,133,000 -6,438,000 -3,631,000 -430,000 -2,955,000 13,501,000 -251,000 4,493,260 751,542 
          capital expenditures
        		-12,455,000 -7,184,000 -14,834,000 -9,263,000 -4,740,000 -7,567,000 -6,378,000 -5,229,000 -9,152,000 -3,793,000 -2,455,000 -4,035,000 -608,000 -1,522,000 -2,038,000 -1,405,000 -370,000 -1,050,000 -740,000 -1,130,000 -530,000 -563,000 -1,906,000 -1,756,000 -500,000 -347,336 -165,191 
          free cash flows
        		-34,584,000 19,747,000 7,797,000 11,558,000 -10,776,000 16,798,000 16,960,000 18,769,000 -15,987,000 14,794,000 2,557,000 -7,821,000 -26,047,000 -7,522,000 -7,262,000 -10,406,000 -21,800,000 -3,831,000 -6,873,000 -7,568,000 -4,161,000 -993,000 -4,861,000 11,745,000 -751,000 4,145,924 586,351 
          investing activities
        		                           
          purchases of marketable investment securities
        		-55,136,000 -37,408,000 -58,474,000 -44,401,000 -48,431,000 -47,320,000 -45,215,000 -52,440,000 -60,754,000 -52,382,000 -50,255,000 -56,355,000 -30,083,000 -2,881,000              
          proceeds from maturities of marketable investment securities
        		39,100,000 54,000,000 54,900,000 44,000,000 36,300,000 60,650,000 36,800,000 36,250,000 50,200,000 48,500,000 43,000,000 45,000,000 50,000,000               
          purchases of debt securities classified as held-to-maturity
        		 0 0 0 -5,569,000                       
          proceeds from sale of equity securities
        		2,681,000                           
          purchases of property and equipment
        		-12,455,000 -7,184,000 -14,834,000 -9,263,000 -4,740,000 -7,567,000 -6,378,000 -5,229,000 -9,152,000 -3,793,000 -2,455,000 -4,035,000 -3,338,000 -1,787,000 -2,038,000 -1,405,000 -402,000 -893,000 -927,000 -913,000 -750,000 -589,000 -1,906,000 -1,756,000 -500,000 -347,336 -165,191 
          proceeds from sale of property and equipment
        		7,000 5,000 19,000 12,000 9,000 7,000 4,000 2,000 5,000 3,000 2,000 3,000 5,000 186,000 1,000   4,000 4,000   1,000      
          net cash from investing activities
        		-25,803,000 8,831,000 -18,389,000 -28,378,000 -22,431,000 5,770,000 -14,789,000 -21,417,000 -19,701,000 -7,672,000 -9,708,000 -15,387,000 16,584,000 -4,482,000 -134,150,000 -27,511,000 -402,000 -30,889,000 -923,000 -34,095,000 -750,000 -588,000 -1,904,000 -1,756,000 -500,000 -347,336 -165,191 
          financing activities
        		                           
          proceeds from exercise of common stock options
        		322,000 2,092,000 77,000 19,000 18,000 373,000 1,571,000 8,000 65,000 72,000 13,000 89,000 95,000 158,000 166,000 110,000 399,000 366,000 1,523,000 1,354,000 991,000 901,000 292,000 329,000 71,000 10,454 745,996 
          payment of employees’ taxes on vested restricted stock units and performance-based restricted stock units
        		-6,598,000                           
          proceeds from contributions to the employee stock purchase plan
        		1,267,000 714,000 220,000 512,000 970,000 647,000 585,000 660,000 1,089,000 682,000 339,000 706,000 982,000 680,000 301,000 614,000 897,000 549,000 371,000 537,000 855,000 408,000 384,000 335,000 488,000   
          repayment of principal portion of finance lease liabilities
        		-24,000 -27,000 -31,000 -31,000 -26,000 -26,000 -24,000 -11,000 -36,000 -36,000 -36,000 -35,000 -35,000 -34,000 -33,000 -31,000 -24,000           
          net cash from financing activities
        		-5,033,000 -4,589,000 -919,000 101,000 -1,553,000 -5,385,000 838,000 42,000 10,644,000 -3,297,000 45,000 226,000 728,000 -750,000 388,000 661,000 1,216,000 126,000 1,894,000 1,891,000 1,510,000 227,820,000 8,150,000 69,361,000 559,000 223,770 76,420,001 
          net change in cash and cash equivalents
        		-52,965,000 31,173,000 3,323,000 -7,456,000 -30,020,000 24,750,000 9,387,000 2,623,000 -15,892,000  -4,651,000 -18,947,000 -8,127,000 -11,232,000 -138,986,000 -35,851,000 -20,616,000 -33,544,000 -5,162,000 -38,642,000 -2,871,000 226,802,000 3,291,000 81,106,000 -192,000 4,369,694 77,006,352 
          beginning of period
        		116,729,000  0 0 119,709,000  0 0 98,841,000  0 0 122,948,000  0 0 329,633,000  0 0 409,852,000  0 0 98,845,000 488 0 
          end of period
        		63,764,000  3,323,000 -7,456,000 89,689,000  9,387,000 2,623,000 82,949,000  -4,651,000 -18,947,000 114,821,000  -138,986,000 -35,851,000 309,017,000  -5,162,000 -38,642,000 406,981,000  3,291,000 81,106,000 98,653,000 4,370,182 77,006,352 
          net income
        		 -2,332,000 -501,000   9,590,000 2,269,000              -4,280,000 -4,889,000   570,000 2,054,767  
          adjustments to reconcile net income to net cash from operating activities:
        		                           
          net gains on equity securities
        		                           
          asset acquisition, net of cash and cash equivalents acquired
        		 -1,000 0                         
          issuance of loan receivable
        		                           
          payment of employees’ taxes on vested restricted stock units
        		 -7,368,000 -1,185,000 -589,000 -2,515,000 -6,379,000 -1,294,000 -615,000 -474,000 -4,015,000 -271,000 -534,000 -314,000 -1,554,000 -46,000 -32,000 -56,000           
          proceeds from lease incentives received
        		 0 0                         
          proceeds from issuance of term debt
        		     0 0 0 10,000,000                   
          beginning of year
        		                           
          end of year
        		                           
          change in fair value of equity securities
        		                           
          change in fair value of trading securities
        		   -1,185,000 1,425,000                       
          disclosure of non-cash investing and financing activities:
        		                           
          asset acquisition, liability for contingent consideration
        		                           
          accrued purchases of property and equipment
        		            2,730,000 265,000   32,000 -157,000 187,000 -217,000 220,000 26,000      
          operating lease assets obtained in exchange for lease obligations
        		             163,000              
          decrease in operating lease assets with corresponding change in lease liabilities
        		                           
          finance lease assets obtained in exchange for lease obligations
        		                           
          property and equipment acquired with tenant improvement allowance
        		            89,000 0    0    0      
          change in fair value of contingent consideration
        		             -300,000 -151,000 -20,398,000 2,562,000           
          acquisition of business, net of cash and cash equivalents acquired
        		             0 -305,000             
          asset acquisitions, net of cash and cash equivalents acquired
        		                           
          supplemental disclosure of cash paid for:
        		                           
          interest
        		                          542,648 
          income taxes
        		                          0 
          common stock issued in acquisition of business
        		             0              
          net changes in cash and cash equivalents
        		                           
          asset acquisition, adjustment to purchase price
        		                           
          deferred acquisition costs
        		                1,026,000           
          medicare advance payment
        		                 -2,999,000 -3,178,000   0 0     
          other liabilities
        		                           
          payment of common stock offering costs
        		                 0 0 0 -336,000       
          asset acquisition, receivable for purchase price adjustment
        		                           
          other accrued liabilities
        		              -1,964,000 1,082,000 29,000 1,667,000 925,000 24,000 -330,000 -1,148,000 1,446,000 359,000 -96,000 617,263 -639,885 
          asset acquisition
        		              0    0         
          contingent consideration in acquisition of business
        		                           
          amortization of debt discounts and issuance costs
        		                     173,000 214,000 228,000 224,000 234,379 440,657 
          loss on extinguishment of debt
        		                           
          proceeds from public offerings of common stock, net of underwriting discounts, commissions and offering costs
        		                     250,537,000      
          repayment of term debt
        		                           
          common stock offering costs incurred but not paid
        		                           
          cashless exercise of common stock warrants
        		                           
          stock compensation expense
        		                  5,210,000 4,766,000 4,913,000  2,118,000 1,653,000 1,577,000 712,287 229,484 
          deferred rent and other liabilities
        		                  131,000 -64,000 -64,000 -101,000 201,000     
          proceeds from public offering of common stock, net of underwriting discounts, commissions and offering costs
        		                           
          repayments on term debt
        		                      -2,500,000     
          depreciation
        		                    233,000 160,000 119,000 102,000 91,000 99,688 91,027 
          amortization of intangibles
        		                         -167 0 
          other non-cash interest
        		                         -176  
          loss on extinguishments of debt
        		                           
          change in fair value of preferred stock warrant liability
        		                         -24 532,910 
          change in fair value of embedded derivative
        		                         -199 100,738 
          change in fair value of convertible promissory note accounted for under the fair value option
        		                         232  
          proceeds from exercise of preferred stock warrants
        		                           
          proceeds from issuance of convertible promissory notes (including 4,756 from related parties for the year ended december 31, 2019), net of issuance costs
        		                           
          proceeds from issuance of convertible promissory note and common stock warrant, net of issuance costs
        		                         256  
          proceeds from issuance of term debt, net of issuance costs
        		                         -145 0 
          repayments on line of credit
        		                         145 0 
          supplemental disclosure of cash paid (refunded) for:
        		                           
          issuance of common stock upon conversion of convertible preferred stock
        		                           
          conversion of preferred stock warrants to common stock warrants
        		                           
          issuance of common stock upon conversion of convertible promissory notes
        		                           
          gain on extinguishment of debt
        		                         431  
          proceeds from issuance of preferred stock and preferred stock warrants
        		                         -17  
          proceeds from issuance of convertible promissory notes (including 4,756 from related parties for the nine months ended september 30, 2019), net of issuance costs
        		                           
          common stock and debt issuance costs incurred but not paid
        		                           
          proceeds from issuance of convertible promissory notes (including 4,756 from related parties for the six months ended june 30, 2019), net of issuance costs
        		                           
          payments of deferred offering costs
        		                           
          deferred rent liability
        		                        -2,000 -419 -684 
          investing activites
        		                           
          proceeds from issuance of convertible promissory notes (including 4,756 from related parties for the three months ended march 31, 2019), net of issuance costs
        		                           
          accrued capital expenditures
        		                        270,000   
          initial public offering costs incurred but not paid
        		                           
          proceeds from initial public offering of common stock, net of underwriting discounts, commissions and issuance costs
        		                         -4,428  
          proceeds from issuance of term debt and preferred stock warrants, net of issuance costs
        		                           
          proceeds from issuance of convertible promissory notes (including 4,756 from related parties), net of issuance costs
        		                           
          proceeds from line of credit
        		                           
          proceeds from issuance of convertible promissory notes (including 4,755,882 from related parties), net of issuance costs
        		                          0 
          payment of deferred offering costs
        		                           
          deferred offering costs and debt issuance costs incurred but not paid