CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands		3 Months Ended		9 Months Ended
		Sep. 30, 2020	Sep. 30, 2019	Sep. 30, 2020	Sep. 30, 2019
Total revenue		$ 125,444	$ 104,672	$ 318,451	$ 301,962
COST OF REVENUE		71,379	53,840	190,011	155,049
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		0	0	1,400	1,018
Loss on termination of cash flow hedge		0	0	3,506	0
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
Net income (loss)	[1]	2,557	2,143	(11,245)	1,710
Convertible note accretion, amortization, and interest, net of tax	[1]	1,975	0	0	0
NET INCOME (LOSS) USED IN DILUTED EPS	[1]	$ 4,532	$ 2,143	$ (11,245)	$ 1,710
NET INCOME (LOSS) PER SHARE
Basic (in dollars per share)		$ 0.02	$ 0.02	$ (0.10)	$ 0.02
Diluted (in dollars per share)		$ 0.04	$ 0.02	$ (0.10)	$ 0.02
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic (in shares)		110,461	103,899	107,605	99,149
Diluted (in shares)		119,191	107,880	107,605	102,766
Clinical Services
Total revenue		$ 108,733	$ 92,565	$ 275,599	$ 267,757
Total gross profit		48,126	45,039	117,312	131,200
Pharma Services
Total revenue		16,711	12,107	42,852	34,205
Total gross profit		$ 5,939	$ 5,793	$ 11,128	$ 15,713

[1] This adjustment compensates for the effects of the if-converted impact of convertible notes in adjusted net income. Since an entity using the if-converted method assumes that a convertible debt instrument was converted into common shares at the beginning of the reporting period, the numerator is adjusted to reverse any recognized interest expense (including any amortization of discounts).