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Consolidated Statements of Operations - USD ($)
shares in Thousands, $ in Thousands
12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Dec. 31, 2016
Sales Revenue, Services, Net [Abstract]      
Total Revenue $ 276,741 $ 240,251 $ 231,808
Cost of revenue 149,476 138,295 133,704
GROSS MARGIN 127,265 101,956 98,104
Operating expenses:      
General and administrative 84,822 70,359 63,926
Research and development 3,001 3,636 4,649
Sales and marketing 29,402 24,001 23,910
Loss on sale of Path Logic 0 1,058 0
Impairment charges 0 0 3,464
Total operating expenses 117,225 99,054 95,949
INCOME FROM OPERATIONS 10,040 2,902 2,155
Interest expense and debt termination fees, net 6,230 5,540 9,998
Other expense (income) (14) 12 0
Income (loss) before taxes 3,824 (2,650) (7,843)
Income tax expense (benefit) (1,184) 2,254 1,701
NET INCOME (LOSS) 2,640 (396) (6,142)
Deemed dividends on preferred stock 10,198 3,645 18,011
Amortization Of Preferred Stock Beneficial Conversion Feature (4,571) 6,902 6,663
Gain on redemption of preferred stock (9,075) 0 0
NET INCOME (LOSS) ATTRIBUTABLE TO COMMON STOCKHOLDERS $ 6,088 $ (10,943) $ (30,816)
Earnings Per Share, Basic and Diluted [Abstract]      
Basic (in dollars per share) $ 0.07 $ (0.14) $ (0.40)
Diluted (in dollars per share) $ 0.07 $ (0.14) $ (0.40)
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING:      
Basic (in shares) 85,618 79,426 77,542
Diluted (in shares) 91,568 79,426 77,542
Clinical Services      
Sales Revenue, Services, Net [Abstract]      
Total Revenue $ 241,873 $ 213,097 $ 210,159
Pharma Services      
Sales Revenue, Services, Net [Abstract]      
Total Revenue $ 34,868 $ 27,154 $ 21,649