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Segment Information (Tables)
12 Months Ended
Dec. 31, 2018
Segment Reporting [Abstract]  
Schedule of Segment Reporting Information, by Segment
The following table summarizes segment information for the years ended December 31, 2018, 2017 and 2016 (in thousands).  
 For the Years Ended December 31,
 20182017
(as adjusted)
2016
(as adjusted)
Net Revenues:   
Clinical Services$241,873 $213,097 $210,159 
Pharma Services34,868 27,154 21,649 
Total Revenue$276,741 $240,251 $231,808 
Cost of Revenue:
Clinical Services$128,297 $121,785 $120,437 
Pharma Services21,179 16,510 13,267 
Total Cost of Revenue$149,476 $138,295 $133,704 
Gross Margin:
Clinical Services$113,576 $91,313 $89,722 
Pharma Services13,689 10,643 8,382 
Total Gross Margin$127,265 $101,956 $98,104