Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020 USD ($) segment	Mar. 31, 2019 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment	2
Segment Reporting Information [Line Items]
Total revenue	$ 106,030	$ 95,577
Total cost of revenue	59,661	48,462
GROSS PROFIT	46,369	47,115
General and administrative	36,344	32,142
Research and development	2,060	1,209
Sales and marketing	13,258	11,216
Total operating expenses	51,662	44,567
(LOSS) INCOME FROM OPERATIONS	(5,293)	2,548
Interest expense, net	819	1,826
Other (income) expense	(223)	5,169
Loss before taxes	(5,889)	(4,447)
Income tax expense (benefit)	1,089	(2,023)
NET LOSS	(6,978)	(2,424)
Clinical Services
Segment Reporting Information [Line Items]
Total revenue	92,982	86,210
Total cost of revenue	48,923	42,651
GROSS PROFIT	44,059	43,559
Pharma Services
Segment Reporting Information [Line Items]
Total revenue	13,048	9,367
Total cost of revenue	10,738	5,811
GROSS PROFIT	$ 2,310	$ 3,556