Segment Information (Details) $ in Thousands	3 Months Ended				6 Months Ended		12 Months Ended
	Jun. 30, 2020 USD ($)	Mar. 31, 2020 USD ($)	Jun. 30, 2019 USD ($)	Mar. 31, 2019 USD ($)	Jun. 30, 2020 USD ($) segment	Jun. 30, 2019 USD ($)	Dec. 31, 2019 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment					2
Segment Reporting Information [Line Items]
Total revenue	$ 86,977		$ 101,713		$ 193,007	$ 197,290
Total cost of revenue	58,971		52,747		118,632	101,209
Total gross profit	28,006		48,966		74,375	96,081
General and administrative	34,613		29,577		70,957	61,719
Research and development	2,105		2,587		4,165	3,796
Sales and marketing	10,195		12,324		23,453	23,540
Total operating expenses	46,913		44,488		98,575	89,055
(Loss) income from operations	(18,907)		4,478		(24,200)	7,026
Interest expense, net	1,548		1,304		2,367	3,130
Other (income) expense, net	(7,405)		(10)		(7,628)	5,159
Loss on extinguishment of debt	1,400		1,018		1,400	1,018	$ 1,400
Loss on termination of cash flow hedge	3,506		0		3,506	0
(Loss) income before taxes	(17,956)		2,166		(23,845)	(2,281)
Income tax (benefit) expense	(11,132)		175		(10,043)	(1,848)
Net (loss) income	(6,824)	$ (6,978)	1,991	$ (2,424)	(13,802)	(433)
Clinical Services
Segment Reporting Information [Line Items]
Total revenue	73,884		88,982		166,866	175,192
Total cost of revenue	48,757		46,380		97,680	89,031
Total gross profit	25,127		42,602		69,186	86,161
Pharma Services
Segment Reporting Information [Line Items]
Total revenue	13,093		12,731		26,141	22,098
Total cost of revenue	10,214		6,367		20,952	12,178
Total gross profit	$ 2,879		$ 6,364		$ 5,189	$ 9,920