Segment Information (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018 USD ($)	Jun. 30, 2017 USD ($)	Jun. 30, 2018 USD ($) segment	Jun. 30, 2017 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment			2
Segment Reporting Information [Line Items]
Revenues	$ 67,746	$ 62,264	$ 131,169	$ 119,693
Cost of Revenue	37,216	34,912	73,336	69,392
GROSS PROFIT	30,530	27,352	57,833	50,301
General and administrative	20,983	18,432	38,050	35,450
Research and development	1,073	947	2,029	1,809
Sales and marketing	7,680	6,132	14,455	11,779
Total operating expenses	29,736	25,511	54,534	49,038
Income from Operations	794	1,841	3,299	1,263
Interest expense, net	(1,407)	(1,411)	(2,892)	(2,775)
Other expense	124	0	62	0
Income (loss) before taxes	(737)	430	345	(1,512)
Income tax expense (benefit)	(357)	(53)	81	(832)
NET INCOME (LOSS)	(380)	483	264	(680)
Clinical Services
Segment Reporting Information [Line Items]
Revenues	59,540	55,547	116,511	108,455
Cost of Revenue	32,035	30,997	63,076	61,704
GROSS PROFIT	27,505	24,550	53,435	46,751
Pharma Services
Segment Reporting Information [Line Items]
Revenues	8,206	6,717	14,658	11,238
Cost of Revenue	5,181	3,915	10,260	7,688
GROSS PROFIT	$ 3,025	$ 2,802	$ 4,398	$ 3,550