Segment Information (Tables)

9 Months Ended

Sep. 30, 2020

Segment Reporting [Abstract]

Summary of Segment Information

The following table summarizes the segment information (in thousands):

	Three Months Ended September 30,				Nine Months Ended September 30,
	2020		2019		2020		2019
Net revenues:
Clinical Services	$	108,733	$	92,565	$	275,599	$	267,757
Pharma Services	16,711		12,107		42,852		34,205
Total revenue	125,444		104,672		318,451		301,962
Cost of revenue:
Clinical Services	60,607		47,526		158,287		136,557
Pharma Services	10,772		6,314		31,724		18,492
Total cost of revenue	71,379		53,840		190,011		155,049
Gross Profit:
Clinical Services	48,126		45,039		117,312		131,200
Pharma Services	5,939		5,793		11,128		15,713
Total gross profit	54,065		50,832		128,440		146,913
Operating expenses:
General and administrative	36,128		33,054		107,085		94,773
Research and development	1,964		2,611		6,129		6,407
Sales and marketing	11,304		11,508		34,757		35,048
Total operating expenses	49,396		47,173		147,971		136,228
Income (loss) from operations	4,669		3,659		(19,531)		10,685
Interest expense, net	2,458		203		4,825		3,333
Other (income) expense, net	(11)		(35)		(7,639)		5,124
Loss on extinguishment of debt	—		—		1,400		1,018
Loss on termination of cash flow hedge	—		—		3,506		—
Income (loss) before taxes	2,222		3,491		(21,623)		1,210
Income tax (benefit) expense	(335)		1,348		(10,378)		(500)
Net income (loss)	$	2,557	$	2,143	$	(11,245)	$	1,710