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Segment Information (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2018 USD ($) segment	Mar. 31, 2017 USD ($)
Segment Reporting [Abstract]
Number of operating segments | segment	2
Segment Reporting Information [Line Items]
Revenues	$ 63,423	$ 57,428
Cost of Revenue	36,120	34,480
GROSS PROFIT	27,303	22,948
General and administrative	17,067	17,018
Research and development	956	862
Sales and marketing	6,775	5,648
Total operating expenses	24,798	23,528
Income (Loss) From Operations	2,505	(580)
Interest expense, net	(1,486)	(1,364)
Other income	63	0
Income (loss) before taxes	1,082	(1,944)
Income tax (benefit) expense	438	(779)
Net income (loss)	644	(1,165)
Clinical Services
Segment Reporting Information [Line Items]
Revenues	56,971	52,907
Cost of Revenue	31,042	30,700
GROSS PROFIT	25,929	22,207
Pharma Services
Segment Reporting Information [Line Items]
Revenues	6,452	4,521
Cost of Revenue	5,078	3,780
GROSS PROFIT	$ 1,374	$ 741

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The aggregate cost of goods produced and sold and services rendered during the reporting period.

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