Segment Information (Details) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2019 USD ($)	Jun. 30, 2019 USD ($)	Mar. 31, 2019 USD ($)	Sep. 30, 2018 USD ($)	Jun. 30, 2018 USD ($)	Mar. 31, 2018 USD ($)	Sep. 30, 2019 USD ($) segment	Sep. 30, 2018 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment							2
Segment Reporting Information [Line Items]
Total revenue	$ 104,672			$ 69,096			$ 301,962	$ 200,266
Total Cost of Revenue	53,840			36,775			155,049	110,111
GROSS PROFIT	50,832			32,321			146,913	90,155
General and administrative	33,054			21,055			94,773	59,106
Research and development	2,611			446			6,407	2,475
Sales and marketing	11,508			6,900			35,048	21,355
Total operating expenses	47,173			28,401			136,228	82,936
INCOME FROM OPERATIONS	3,659			3,920			10,685	7,219
Interest expense, net	203			1,873			3,333	4,766
Other (income) expense	(35)			(30)			5,124	31
Loss on extinguishment of debt	0			0			1,018	0
Income before taxes	3,491			2,077			1,210	2,422
Income tax expense (benefit)	1,348			54			(500)	135
NET INCOME	2,143	$ 1,991	$ (2,424)	2,023	$ (380)	$ 644	1,710	2,287
Clinical Services
Segment Reporting Information [Line Items]
Total revenue	92,565			59,449			267,757	175,960
Total Cost of Revenue	47,526			31,509			136,557	94,586
GROSS PROFIT	45,039			27,940			131,200	81,374
Pharma Services
Segment Reporting Information [Line Items]
Total revenue	12,107			9,647			34,205	24,306
Total Cost of Revenue	6,314			5,266			18,492	15,525
GROSS PROFIT	$ 5,793			$ 4,381			$ 15,713	$ 8,781