NeoGenomics (NEO) 10-Q 13 Nov 19 2019 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2019	Nov. 08, 2019
Cover page.
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2019
Document Transition Report	false
Entity File Number	001-35756
Entity Registrant Name	NEOGENOMICS, INC.
Entity Incorporation, State or Country Code	NV
Entity Tax Identification Number	74-2897368
Entity Address, Address Line One	12701 Commonwealth Drive,
Entity Address, Address Line Two	Suite 9,
Entity Address, State or Province	FL
Entity Address, City or Town	Fort Myers,
Entity Address, Postal Zip Code	33913
City Area Code	(239)
Local Phone Number	768-0600
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of 12(b) Security	Common stock ($0.001 par value)
Trading Symbol	NEO
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		104,407,597
Entity Central Index Key	0001077183
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Amendment Flag	false
Current Fiscal Year End Date	--12-31

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Current assets
Cash and cash equivalents	$ 178,891	$ 9,811
Accounts receivable, net	91,133	76,919
Inventories	12,632	8,650
Prepaid assets	8,742	7,727
Other current assets	603	561
Total current assets	292,001	103,668
Property and equipment (net of accumulated depreciation of $64,165 and $50,127, respectively)	62,488	60,888
Operating lease right-of-use assets	25,797
Intangible assets, net	129,084	140,029
Goodwill	198,571	197,892
Other assets	3,214	2,538
Total assets	711,155	505,015
Current liabilities
Accounts payable	17,995	17,779
Accrued compensation	26,298	19,062
Accrued expenses and other liabilities	7,900	8,986
Short-term portion of financing obligations	5,750
Short-term portion of financing obligations		6,298
Short-term portion of operating leases	3,527
Short-term portion of term loan	6,250	7,873
Pharma contract liability	1,187	927
Total current liabilities	68,907	60,925
Long-term liabilities
Long-term portion of finance lease obligations	3,982
Long-term portion of finance lease obligations		5,250
Long-term portion of operating leases	23,870
Long-term portion of term loan, net	93,027	87,880
Revolving credit facility	0	5,000
Other long term liabilities	4,674	3,060
Deferred income tax liability, net	19,688	22,457
Total long-term liabilities	145,241	123,647
Total liabilities	214,148	184,572
Stockholders' equity
Common stock, $0.001 par value, (250,000,000 shares authorized; 104,145,895 and 94,465,440 shares issued and outstanding, respectively)	104	94
Additional paid-in capital	516,936	340,291
Accumulated other comprehensive loss	(2,380)	(579)
Accumulated deficit	(17,653)	(19,363)
Total stockholders’ equity	497,007	320,443
Total liabilities and stockholders' equity	$ 711,155	$ 505,015

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 64,165	$ 50,127
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized	250,000,000	250,000,000
Common stock, shares issued	104,145,895	94,465,440
Common stock, shares outstanding	104,145,895	94,465,440

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Total revenue	$ 104,672	$ 69,096	$ 301,962	$ 200,266
COST OF REVENUE	53,840	36,775	155,049	110,111
GROSS PROFIT	50,832	32,321	146,913	90,155
Operating expenses:
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	2,023	1,710	2,287
Deemed dividends on preferred stock and amortization of beneficial conversion feature	0	0	0	5,627
Gain on redemption of preferred stock	0	0	0	(9,075)
NET INCOME ATTRIBUTABLE TO COMMON STOCKHOLDERS	$ 2,143	$ 2,023	$ 1,710	$ 5,735
INCOME PER SHARE ATTRIBUTABLE TO COMMON STOCKHOLDERS
Basic (in dollars per share)	$ 0.02	$ 0.02	$ 0.02	$ 0.07
Diluted (in dollars per share)	$ 0.02	$ 0.02	$ 0.02	$ 0.06
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic (in shares)	103,899	87,253	99,149	87,381
Diluted (in shares)	107,880	90,899	102,766	89,925
Clinical Services
Total revenue	$ 92,565	$ 59,449	$ 267,757	$ 175,960
GROSS PROFIT	45,039	27,940	131,200	81,374
Pharma Services
Total revenue	12,107	9,647	34,205	24,306
GROSS PROFIT	$ 5,793	$ 4,381	$ 15,713	$ 8,781

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement of Comprehensive Income [Abstract]
NET INCOME	$ 2,143	$ 2,023	$ 1,710	$ 2,287
OTHER COMPREHENSIVE INCOME:
Foreign currency translation adjustments	0	(13)	0	(36)
(Loss) gain on effective cash flow hedges	(217)		(1,801)
(Loss) gain on effective cash flow hedges		292		298
Total other comprehensive (loss) income	(217)	279	(1,801)	262
COMPREHENSIVE INCOME (LOSS)	$ 1,926	$ 2,302	$ (91)	$ 2,549

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
CASH FLOWS FROM OPERATING ACTIVITIES
Net income	$ 1,710	$ 2,287
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	15,200	11,477
Loss on disposal of assets	451	278
Loss on extinguishment of debt	1,018	0
Amortization of intangibles	7,482	4,255
Amortization of debt issue costs	323	392
Non-cash stock based compensation	7,727	5,148
Non-cash operating lease expense	3,224
Changes in assets and liabilities, net
Accounts receivable, net	(14,219)	(2,267)
Inventories	(3,982)	644
Prepaid assets	(1,013)	(559)
Other current assets	(381)	(1,749)
Accounts payable, accrued and other liabilities	2,470	9,427
Net cash provided by operating activities	20,010	29,333
CASH FLOWS FROM INVESTING ACTIVITIES
Purchases of property and equipment	(13,953)	(11,091)
Acquisition adjustment	399	0
Net cash used in investing activities	(13,554)	(11,091)
CASH FLOWS FROM FINANCING ACTIVITIES
Advances on revolving credit facility	0	10,000
Repayment of revolving credit facility	(5,000)	(35,400)
Redemption of preferred stock	0	(50,096)
Repayment of equipment and other loans	(5,481)	(4,774)
Proceeds from term loan	100,000	30,000
Repayment of term loan	(96,750)	(3,187)
Payments of debt issue costs	(1,051)	(576)
Issuance of common stock, net	10,132	6,535
Proceeds from equity offering, net	160,774	134,910
Net cash provided by financing activities	162,624	87,412
Effects of foreign exchange rate changes on cash and cash equivalents	0	(35)
Net change in cash and cash equivalents	169,080	105,619
Cash and cash equivalents, beginning of period	9,811	12,821
Cash and cash equivalents, end of period	178,891	118,440
Supplemental disclosure of cash flow information:
Cash paid for operating lease liabilities	2,878
Interest paid	4,295	4,722
Income taxes paid (refunded), net	316	(76)
Supplemental disclosure of non-cash investing and financing information:
Working capital adjustment related to acquisition	1,977	0
Equipment acquired under loan obligations	3,665	7,569
Property and equipment included in accounts payable	$ 810	$ 571

CONSOLIDATED STATEMENTS OF REDE

CONSOLIDATED STATEMENTS OF REDEEMABLE CONVERTIBLE PREFERRED STOCK AND STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Series A Redeemable Convertible Preferred Stock	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit
Redeemable preferred stock, beginning balance (in shares) at Dec. 31, 2017		6,864,000
Redeemable preferred stock, beginning balance at Dec. 31, 2017		$ 32,615
Increase (Decrease) in Temporary Equity [Roll Forward]
Redemption of Series A Preferred Stock				$ (21,300)
Redeemable preferred stock, ending balance (in shares) at Mar. 31, 2018		6,864,000
Redeemable preferred stock, ending balance at Mar. 31, 2018	$ 35,471	$ 35,471
Beginning balance (in shares) at Dec. 31, 2017			80,462,574
Beginning balance at Dec. 31, 2017	171,962		$ 80	194,687	$ 274	$ (23,079)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			38,620
Common stock issuance ESPP Plan	267			267
Stock issuance fees and expenses	(97)			(97)
Foreign currency translation adjustments	(45)				(45)
(Loss) gain on effective cash flow hedges	270				270
Issuance of common stock for stock options (in shares)			67,259
Issuance of common stock for stock options	216		$ 1	215
Deemed dividends on preferred stock and amortization of beneficial conversion feature	(2,856)	$ 2,856		(2,856)
ESPP expense	54			54
Stock based compensation expense - options and restricted stock	1,570			1,570
NET INCOME	644					644
Ending balance (in shares) at Mar. 31, 2018			80,568,453
Ending balance at Mar. 31, 2018	171,985		$ 81	193,840	499	(22,435)
Redeemable preferred stock, beginning balance (in shares) at Dec. 31, 2017		6,864,000
Redeemable preferred stock, beginning balance at Dec. 31, 2017		$ 32,615
Redeemable preferred stock, ending balance (in shares) at Sep. 30, 2018		0
Redeemable preferred stock, ending balance at Sep. 30, 2018		$ 0
Beginning balance (in shares) at Dec. 31, 2017			80,462,574
Beginning balance at Dec. 31, 2017	171,962		$ 80	194,687	274	(23,079)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
(Loss) gain on effective cash flow hedges	298
NET INCOME	2,287
Gain on redemption of preferred stock	9,075
Ending balance (in shares) at Sep. 30, 2018			92,980,783
Ending balance at Sep. 30, 2018	303,559		$ 93	322,592	536	(19,662)
Redeemable preferred stock, beginning balance (in shares) at Mar. 31, 2018		6,864,000
Redeemable preferred stock, beginning balance at Mar. 31, 2018	35,471	$ 35,471
Increase (Decrease) in Temporary Equity [Roll Forward]
Redemption of Series A Preferred Stock (in shares)		(6,864,000)
Redemption of Series A Preferred Stock	(21,348)	$ (37,823)		(21,348)
Redeemable preferred stock, ending balance (in shares) at Jun. 30, 2018		0
Redeemable preferred stock, ending balance at Jun. 30, 2018		$ 0
Beginning balance (in shares) at Mar. 31, 2018			80,568,453
Beginning balance at Mar. 31, 2018	171,985		$ 81	193,840	499	(22,435)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			31,686
Common stock issuance ESPP Plan	231			231
Stock issuance fees and expenses	(46)			(46)
Foreign currency translation adjustments	24				24
(Loss) gain on effective cash flow hedges	(266)				(266)
Issuance of common stock for stock options (in shares)			897,942
Issuance of common stock for stock options	4,918			4,918
Deemed dividends on preferred stock and amortization of beneficial conversion feature	(2,352)	2,352		(2,352)
ESPP expense	56			56
Stock based compensation expense - options and restricted stock	2,277			2,277
NET INCOME	(380)					(380)
Gain on redemption of preferred stock	9,075	$ 0		9,075
Ending balance (in shares) at Jun. 30, 2018			81,498,081
Ending balance at Jun. 30, 2018	164,209		$ 81	185,556	257	(21,685)
Redeemable preferred stock, ending balance (in shares) at Sep. 30, 2018		0
Redeemable preferred stock, ending balance at Sep. 30, 2018		$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			16,689
Common stock issuance ESPP Plan	267			267
Stock issuance fees and expenses	(163)			(163)
Foreign currency translation adjustments	(13)				(13)
(Loss) gain on effective cash flow hedges	292				292
Issuance of restricted stock, net of forfeitures (in shares)			62,182
Issuance of restricted stock, net of forfeitures	(297)			(297)
Issuance of common stock - Public Offering (in shares)			11,270,000
Issuance of common stock - Public Offering	135,071		$ 11	135,060
Issuance of common stock for stock options (in shares)			133,831
Issuance of common stock for stock options	979		$ 1	978
ESPP expense	56			56
Stock based compensation expense - options and restricted stock	1,135			1,135
NET INCOME	2,023					2,023
Gain on redemption of preferred stock	0
Ending balance (in shares) at Sep. 30, 2018			92,980,783
Ending balance at Sep. 30, 2018	303,559		$ 93	322,592	536	(19,662)
Redeemable preferred stock, beginning balance (in shares) at Dec. 31, 2018		0
Redeemable preferred stock, beginning balance at Dec. 31, 2018		$ 0
Redeemable preferred stock, ending balance (in shares) at Mar. 31, 2019		0
Redeemable preferred stock, ending balance at Mar. 31, 2019		$ 0
Beginning balance (in shares) at Dec. 31, 2018			94,465,440
Beginning balance at Dec. 31, 2018	320,443		$ 94	340,291	(579)	(19,363)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			36,032
Common stock issuance ESPP Plan	419			419
Stock issuance fees and expenses	(66)			(66)
(Loss) gain on effective cash flow hedges	(557)				(557)
Issuance of restricted stock, net of forfeitures (in shares)			182,502
Issuance of common stock for stock options (in shares)			619,536
Issuance of common stock for stock options	3,894		$ 1	3,893
ESPP expense	119			119
Stock based compensation expense - options and restricted stock	2,020			2,020
NET INCOME	(2,424)					(2,424)
Ending balance (in shares) at Mar. 31, 2019			95,303,510
Ending balance at Mar. 31, 2019	323,848		$ 95	346,676	(1,136)	(21,787)
Redeemable preferred stock, beginning balance (in shares) at Dec. 31, 2018		0
Redeemable preferred stock, beginning balance at Dec. 31, 2018		$ 0
Redeemable preferred stock, ending balance (in shares) at Sep. 30, 2019		0
Redeemable preferred stock, ending balance at Sep. 30, 2019		$ 0
Beginning balance (in shares) at Dec. 31, 2018			94,465,440
Beginning balance at Dec. 31, 2018	320,443		$ 94	340,291	(579)	(19,363)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
(Loss) gain on effective cash flow hedges	$ (1,801)
Issuance of common stock for stock options (in shares)	1,439,869
NET INCOME	$ 1,710
Gain on redemption of preferred stock	0
Ending balance (in shares) at Sep. 30, 2019			104,145,895
Ending balance at Sep. 30, 2019	497,007		$ 104	516,936	(2,380)	(17,653)
Redeemable preferred stock, beginning balance (in shares) at Mar. 31, 2019		0
Redeemable preferred stock, beginning balance at Mar. 31, 2019		$ 0
Redeemable preferred stock, ending balance (in shares) at Jun. 30, 2019		0
Redeemable preferred stock, ending balance at Jun. 30, 2019		$ 0
Beginning balance (in shares) at Mar. 31, 2019			95,303,510
Beginning balance at Mar. 31, 2019	323,848		$ 95	346,676	(1,136)	(21,787)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			37,255
Common stock issuance ESPP Plan	653			653
Stock issuance fees and expenses	(211)			(211)
(Loss) gain on effective cash flow hedges	(1,027)				(1,027)
Issuance of restricted stock, net of forfeitures (in shares)			(633)
Working capital adjustment related to acquisition (in shares)			(99,524)
Working capital adjustment related to acquisition	(1,977)			(1,977)
Issuance of common stock - Public Offering (in shares)			8,050,000
Issuance of common stock - Public Offering	160,774		$ 8	160,766
Issuance of common stock for stock options (in shares)			543,604
Issuance of common stock for stock options	3,370		$ 1	3,369
ESPP expense	162			162
Stock based compensation expense - options and restricted stock	2,151			2,151
NET INCOME	1,991					1,991
Ending balance (in shares) at Jun. 30, 2019			103,834,212
Ending balance at Jun. 30, 2019	489,734		$ 104	511,589	(2,163)	(19,796)
Redeemable preferred stock, ending balance (in shares) at Sep. 30, 2019		0
Redeemable preferred stock, ending balance at Sep. 30, 2019		$ 0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)			28,672
Common stock issuance ESPP Plan	564			564
Stock issuance fees and expenses	23			23
(Loss) gain on effective cash flow hedges	(217)				(217)
Issuance of restricted stock, net of forfeitures (in shares)			(6,070)
Issuance of restricted stock, net of forfeitures	(688)			(688)
Issuance of common stock for stock options (in shares)			289,081
Issuance of common stock for stock options	2,173			2,173
ESPP expense	144			144
Stock based compensation expense - options and restricted stock	3,131			3,131
NET INCOME	2,143					2,143
Gain on redemption of preferred stock	0
Ending balance (in shares) at Sep. 30, 2019			104,145,895
Ending balance at Sep. 30, 2019	$ 497,007		$ 104	$ 516,936	$ (2,380)	$ (17,653)

Nature of Business and Basis of

Nature of Business and Basis of Presentation	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business and Basis of Presentation	Nature of Business and Basis of Presentation NeoGenomics, Inc., a Nevada corporation, and its subsidiaries (the “Parent”, “Company”, or “NeoGenomics”), operates as a certified, high complexity clinical laboratory in accordance with the federal government’s Clinical Laboratory Improvement Act, as amended (“CLIA”), and is dedicated to the delivery of clinical diagnostic services to pathologists, oncologists, urologists, hospitals, and other laboratories as well as providing clinical trial services to pharmaceutical firms. The accompanying interim consolidated financial statements are unaudited and have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial information. These accompanying consolidated financial statements include the accounts of the Parent and its subsidiaries. All intercompany transactions and balances have been eliminated in the accompanying consolidated financial statements. Certain information and footnote disclosures normally included in the Company’s annual audited consolidated financial statements and accompanying notes have been condensed or omitted in these accompanying interim consolidated financial statements and footnotes. Accordingly, the accompanying interim consolidated financial statements included herein should be read in conjunction with the audited consolidated financial statements and accompanying notes included in the Company’s annual report on Form 10-K for the year ended December 31, 2018. The year-end consolidated balance sheet information has been derived from the audited consolidated financial statements in the annual report as of December 31, 2018. The results of operations presented in this quarterly report on Form 10-Q are not necessarily indicative of the results of operations that may be expected for any future periods. In the opinion of management, these unaudited consolidated financial statements include all adjustments and accruals, consisting only of normal, recurring adjustments that are necessary for a fair statement of the results of all interim periods reported herein. The Company reports its activities in two operating segments; the Clinical Services Segment and the Pharma Services Segment. These reportable segments deliver testing services to hospitals, pathologists, oncologists, clinicians, pharmaceutical firms and researchers and represent 100% of the Company’s consolidated assets, net revenues and net income for each period presented. For further financial information about these segments, see Note N, Segment Information, in the accompanying notes to the consolidated financial statements. The Company has evaluated events through the filing date of the financial statements. There were no subsequent events that require disclosure. Immaterial Restatement and Reclassification Subsequent to the issuance of the September 30, 2018 consolidated financial statements, during the third quarter of 2019 the Company identified that the gain on redemption of preferred stock for the three months ended June 30, 2018 of $9.1 million was incorrectly presented as a loss on redemption with an offsetting decrease to additional paid in capital in the consolidated statements of redeemable preferred stock and stockholders' equity. As a result, the Company has revised the presentation of the impact of the redemption on the carrying value of the preferred stock in the consolidated statements of redeemable preferred stock and stockholders' equity for the three month period ended June 30, 2018. There was no impact to the beginning and ending balances of preferred stock as a result of this error. In addition, the Company identified that it has historically incorrectly classified deemed dividends, amortization of BCF and redemption value measurement adjustments on preferred stock as adjustments to its accumulated deficit. As a result, the Company has corrected the historical presentation of all amounts of deemed dividends, amortization of BCF and redemption value measurement adjustments for the three year period ended December 31, 2017 as a cumulative reduction of additional paid-in capital as of December 31, 2017 and other applicable periods as further disclosed within the table below. The adjustments to correct for these errors have no impact to the previously reported consolidated statements of operations, comprehensive income, or cash flows. The adjustments to correct for these errors also have no impact to total preferred stock or total stockholders' equity as presented within the consolidated balance sheets or statements of redeemable convertible preferred stock and stockholders' equity. Management has considered these errors from a qualitative and quantitative perspective and believes the impact of these errors is not material to previously issued consolidated financial statements. The Company has restated its accompanying consolidated statements of redeemable preferred stock and stockholders’ equity and consolidated balance sheets to correct for these immaterial errors for the applicable periods presented in this Form 10-Q. Additionally, the Company made certain other presentation reclassifications to previously reported information related to the redemption of preferred stock in June 2018, including reclassifying $21.3 million of deemed dividends on preferred stock and amortization of beneficial conversion feature to redemption of Series A preferred stock within additional paid-in capital in the accompanying consolidated statements of redeemable preferred stock and stockholders’ equity. Such presentation reclassifications have no impact to total additional paid-in capital for any period. The following table shows the amounts of additional paid-in capital, accumulated deficit, deemed dividends on preferred stock and amortization of beneficial conversion feature, and gain on redemption of preferred stock for the applicable periods, as previously reported and as corrected in the consolidated statements of redeemable preferred stock and stockholders' equity and balance sheets (in thousands): As Previously Reported As Corrected Additional Paid-in Capital Accumulated Deficit Additional Paid-in Capital Accumulated Deficit Balance at December 31, 2017 $ 230,030 $ (58,422) $ 194,687 $ (23,079) Deemed dividends on preferred stock and amortization of beneficial conversion feature — (2,856) (2,856) — Balance at March 31, 2018 232,039 (60,634) 193,840 (22,435) Deemed dividends on preferred stock and amortization of beneficial conversion feature* 419 (2,771) (2,352) — Gain on redemption of preferred stock — 9,075 9,075 — Balance at June 30, 2018 217,451 (53,580) 185,556 (21,685) Balance at September 30, 2018 354,487 (51,557) 322,592 (19,662) Balance at December 31, 2018 372,186 (51,258) 340,291 (19,363) Balance at March 31, 2019 378,571 (53,682) 346,676 (21,787) Balance at June 30, 2019 $ 543,484 $ (51,691) $ 511,589 $ (19,796) *The deemed dividends on preferred stock and amortization of beneficial conversion feature within additional paid-in capital as previously reported as shown here reflects a $21.3 million reclassification to the redemption of Series A preferred stock within additional paid-in capital. As discussed above, such presentation reclassifications have no impact to total paid-in capital for any period. The following table shows the amounts of the redemption of preferred stock, deemed dividends on preferred stock and amortization of beneficial conversion feature, and gain on redemption of preferred stock for the applicable periods, as previously reported and as currently reported in the consolidated statements of redeemable preferred stock and stockholders' equity (in thousands): As Previously Reported As Currently Reported Series A Redeemable Convertible Preferred Stock Immaterial Correction of an Error Reclassification Series A Redeemable Convertible Preferred Stock Balance at March 31, 2018 $ 35,471 $ — $ — $ 35,471 Redemption of Series A Preferred Stock (50,096) — 12,273 (37,823) Deemed dividends on preferred stock and amortization of beneficial conversion feature 5,550 18,150 (21,348) 2,352 Gain on redemption of preferred stock 9,075 (18,150) 9,075 — Balance at June 30, 2018 $ — $ — $ — $ —

Recently Adopted and Issued Acc

Recently Adopted and Issued Accounting Guidance	9 Months Ended
	Sep. 30, 2019
Accounting Changes and Error Corrections [Abstract]
Recently Adopted and Issued Accounting Guidance	Recently Adopted and Issued Accounting Guidance Adopted In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2016-02, Leases (Topic 842). Topic 842 supersedes the lease requirements in FASB ASC 840, Leases (Topic 840). Under Topic 842, lessees are required to recognize assets and liabilities on the balance sheet for most operating leases and provide enhanced disclosures. The Company adopted Topic 842 effective January 1, 2019 using the modified retrospective method and using the optional transition method to apply the new lease accounting standard prospectively as of January 1, 2019, rather than as of the earliest period presented. In addition, the Company elected the package of practical expedients permitted under the transition guidance within the new standard. Adoption of this standard resulted in the recording of net operating lease right-of-use (“ROU”) assets of $9.7 million and corresponding operating lease liabilities of $10.1 million upon adoption. The adoption did not materially impact the Company’s Consolidated Statements of Operations or Cash Flows. Refer to Note C, Leases, herein for further details regarding the impact of the adoption of Topic 842 and other information related to the Company’s lease portfolio. Issued In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (Topic 326) : Measurement of Credit Losses on Financial Instruments , which modifies the measurement and recognition of credit losses for most financial assets and certain other instruments. The new standard requires the use of forward-looking expected credit loss models based on historical experience, current conditions, and reasonable and supportable forecasts that affect the collectability of the reported amount, which may result in earlier recognition of credit losses under the new standard. This new standard also requires that credit losses related to available-for-sale debt securities be recorded as an allowance through net income rather than reducing the carrying amount under the current, other-than-temporary-impairment model. The standard is effective for public business entities for annual periods beginning after December 15, 2019, and interim periods within those years. The Company plans to implement the new standard in the first quarter of 2020 using a modified retrospective approach, and is in the process of reviewing its credit loss models to assess the impact of the adoption of the standard on its consolidated financial statements. In January 2017, the FASB issued ASU 2017-04, Intangibles – Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment . This new guidance eliminates the requirement to calculate the implied fair value of goodwill to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value. Topic 350 is effective for public business entities for fiscal years beginning after December 15, 2019, including interim periods within those fiscal years, and early adoption is permitted. The Company will adopt this pronouncement on January 1, 2020 and does not expect the impact of the adoption of the standard to have a material impact on its consolidated financial statements. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement: Disclosure Framework – Changes to the Disclosure Requirements for Fair Value Measurement , which adds and modifies certain disclosure requirements for fair value measurements. Under the new guidance, entities will no longer be required to disclose the amount of and reasons for transfers between Level 1 and Level 2 of the fair value hierarchy, or valuation processes for Level 3 fair value measurements. However, public companies will be required to disclose the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements, and related changes in unrealized gains and losses included in other comprehensive income. This update is effective for annual periods beginning after December 15, 2019, and interim periods within those periods, and early adoption is permitted. Certain provisions of the ASU must be adopted retrospectively, while others must be adopted prospectively. The Company will adopt this pronouncement on January 1, 2020 and does not expect the impact of the adoption of the standard to have a material impact on its consolidated financial statements. In August 2018, the FASB issued ASU 2018-15, Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract , which changes the accounting for implementation costs incurred in a cloud computing arrangement that is a service contract. The update aligns the requirements for capitalizing implementation costs incurred in a hosting arrangement with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The implementation costs should be presented as a prepaid asset on the balance sheet and expensed over the term of the hosting arrangement. The standard is effective for annual periods, including interim periods within those annual periods, beginning after December 15, 2019 and early adoption is permitted. The Company will adopt this pronouncement on January 1, 2020 and does not expect the impact of the adoption of the standard to have a material impact on its consolidated financial statements.

Leases

Leases	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Leases	Leases The Company leases corporate offices and laboratory space throughout the world, all of which are classified as operating leases expiring at various dates and generally have terms ranging from 1 to 10 years. Leases with an initial term of 12 months or less are not recorded on the balance sheet. Some of the Company’s real estate lease agreements include options to either renew or early terminate the lease. Leases with renewal options allow the Company to extend the lease term typically between 1 and 5 years. When it is reasonably certain that the Company will exercise an option to renew or terminate a lease, these options are considered in determining the classification and measurement of the lease. Lease liabilities are recorded based on the present value of the future lease payments over the lease term and assessed as of the commencement date. Incentives received from landlords, such as reimbursements for tenant improvements and rent abatement periods, effectively reduce the total lease payments owed for leases. Certain real estate leases also include executory costs such as common area maintenance (non-lease component), as well as property insurance and property taxes (non-components). Lease payments, which may include lease components, non-lease components and non-components, are included in the measurement of the Company’s lease liabilities to the extent that such payments are either fixed amounts or variable amounts based on a rate or index (fixed in substance) as stipulated in the lease contract. Any actual costs in excess of such amounts are expensed as incurred as variable lease cost. The Company utilizes its incremental borrowing rate by lease term in order to calculate the present value of our future lease payments. The discount rate represents a risk-adjusted rate on a secured basis, and is the rate at which the Company would borrow funds to satisfy the scheduled lease liability payment streams commensurate with the lease term. On January 1, 2019, the discount rate used on existing leases at adoption was determined based on the remaining lease term using available data as of that date. For new or renewed leases starting in 2019, the discount rate is determined using the incremental borrowing rate at lease commencement and based on the lease term. Operating Leases Operating lease costs include an immaterial amount of variable lease cost, and are recorded in cost of revenue and general and administrative expenses, depending on the nature of the leased asset. Aside from variable lease costs, operating lease costs represent fixed lease payments recognized on a straight-line basis over the lease term. As of September 30, 2019, the maturities of our operating lease liabilities and a reconciliation to the present value of lease liabilities were as follows (in thousands): Remaining Lease Payments Remainder of 2019 $ 1,540 2020 4,969 2021 5,050 2022 4,213 2023 4,076 2024 4,097 Thereafter 12,705 Total remaining lease payments 36,650 Less: imputed interest (9,253) Total operating lease liabilities 27,397 Less: current portion (3,527) Long-term operating lease liabilities $ 23,870 Weighted-average remaining lease term (in years) 8.1 Weighted-average discount rate 6.5 % The following summarizes additional supplemental data related to our operating leases (in thousands): Three Months Ended Nine Months Ended Operating lease costs $ 1,271 $ 4,365 Nine Months Ended Right-of-use assets obtained in exchange for operating lease liabilities $ 19,341 Lease contracts that have been executed but have not yet commenced are excluded from the tables above. As of September 30, 2019, the Company has entered into $50.3 million of contractually binding minimum lease payments for leases executed but not yet commenced. This amount primarily relates to the lease of the laboratory and headquarters facility in Fort Myers, Florida that is expected to commence in 2021. In addition to the minimum lease payments, the Company will pay $25.0 million relating to the construction of the underlying assets. This amount will be initially recorded as a prepaid asset. On the commencement date of the lease, the amount will be reclassed to either the right-of-use asset or leasehold improvements as appropriate and amortized accordingly. Construction of this facility has not yet commenced. The Company is not expected to control the underlying assets during the construction period and therefore is not considered the owner of the underlying assets for accounting purposes. As previously disclosed in our 2018 Annual Report on Form 10-K and under the previous lease accounting standard, future minimum lease payments for operating leases having initial or remaining noncancellable lease terms in excess of one year were as follows (in thousands): Years ending December 31, 2019 $ 5,247 2020 2,798 2021 1,082 2022 453 2023 92 Thereafter — Total minimum lease payments $ 9,672

Revenue Recognition and Contrac

Revenue Recognition and Contractual Adjustments	9 Months Ended
	Sep. 30, 2019
Revenue from Contract with Customer [Abstract]
Revenue Recognition and Contractual Adjustments	Revenue Recognition and Contractual Adjustments The Company has two operating segments for which it recognizes revenue; Clinical Services and Pharma Services. The Clinical Services segment provides various clinical testing services to community-based pathology practices, hospital pathology labs and academic centers with reimbursement from various payers including client direct billing, commercial insurance, Medicare and other government payers, and patients. The Pharma Services segment supports pharmaceutical firms in their drug development programs by providing testing services and data analytics for clinical trials and research. Clinical Services Revenue The Company’s specialized diagnostic services are performed based on a written test requisition form or electronic equivalent. The performance obligation is satisfied and revenues are recognized once the diagnostic services have been performed and the results have been delivered to the ordering physician. These diagnostic services are billed to various payers, client direct billing, commercial insurance, Medicare and other government payers, and patients. Revenue is recorded for all payers based on the amount expected to be collected, which considers implicit price concessions. Implicit price concessions represent differences between amounts billed and the estimated consideration the Company expects to receive based on negotiated discounts, historical collection experience and other anticipated adjustments, including anticipated payer denials. Collection of consideration the Company expects to receive typically occurs within 30 to 60 days of billing for commercial insurance, Medicare and other governmental and self-pay payers and within 60 to 90 days of billing for client payers. Pharma Services Revenue The Company’s Pharma Services segment generally enters into contracts with pharmaceutical and biotech customers as well as other Contract Research Organizations (“CROs”) to provide research and clinical trial services ranging in duration from one month to several years. The Company records revenue on a unit-of-service basis based on number of units completed and the total expected contract value. The total expected contract value is estimated based on historical experience of total contracted units compared to realized units as well as known factors on a specific contract-by-contract basis. Certain contracts include upfront fees, final settlement amounts or billing milestones that may not align with the completion of performance obligations. The value of these upfront fees or final settlement amounts is usually recognized over time based on the number of units completed, which aligns with the progress of the Company towards fulfilling its obligations under the contract. The Company also enters into other contracts, such as validation studies, for which the sole deliverable is a final report that is sent to sponsors at the completion of contracted activities. For these contracts, revenue is recognized at a point in time upon delivery of the final report to the sponsor. Any contracts that contain multiple performance obligations and include both units-of-service and point-in-time deliverables are accounted for as separate performance obligations and revenue is recognized as previously disclosed. The Company negotiates billing schedules and payment terms on a contract-by-contract basis. While the contract terms generally provide for payments based on a unit-of-service arrangement, the billing schedules, payment terms and related cash payments may not align with the performance of services and, as such, may not correspond to revenue recognized in any given period. Amounts collected in advance of services being provided are deferred as contract liabilities on the Consolidated Balance Sheet. The associated revenue is recognized and the contract liability is reduced as the contracted services are subsequently performed. Contract assets are established for revenue that has been recognized but not yet billed. These contract assets are reduced once the customer is invoiced and a corresponding receivable is recorded. Additionally, certain costs to obtain contracts, primarily for sales commissions, are capitalized when incurred and are amortized over the term of the contract. Amounts capitalized for contracts with an initial contract term of twelve months or less are classified as current assets. All others are classified as non-current assets. Most contracts are terminable by the customer, either immediately or according to advance notice terms specified within the contracts. All contracts require payment of fees to the Company for services rendered through the date of termination and may require payment for subsequent services necessary to conclude the study or close out the contract. The following table summarizes the values of contract assets, capitalized commissions and contract liabilities (in thousands): September 30, 2019 December 31, 2018 Current pharma contract assets (1) $ 234 $ 86 Long-term pharma contract assets (2) 627 268 Total pharma contract assets $ 861 $ 354 Current pharma capitalized commissions (1) $ 222 $ 271 Long-term pharma capitalized commissions (2) 839 650 Total pharma capitalized commissions $ 1,061 $ 921 Current pharma contract liabilities $ 1,187 $ 927 Long-term pharma contract liabilities (3) 1,898 1,652 Total pharma contract liabilities $ 3,085 $ 2,579 (1) Current pharma contract assets and Current pharma capitalized commissions are classified as “Other current assets” on the Consolidated Balance Sheets. (2) Long-term pharma contract assets and Long-term pharma capitalized commissions are classified as “Other assets” on the Consolidated Balance Sheets. (3) Long-term pharma contract liabilities are classified as “Other long-term liabilities” on the Consolidated Balance Sheets. Pharma contract assets increased $0.5 million, or 143%, from December 31, 2018 to September 30, 2019. Pharma contract liabilities increased $0.5 million, or 20%, during the same period while capitalized commissions also increased by $0.1 million, or 15%. These increases are due to higher upfront fees driven by increases in the volume of Pharma contracts in process. Revenue recognized for the three and nine months ended September 30, 2019 related to Pharma contract liability balances outstanding at the beginning of the period was $0.1 million and $2.0 million, respectively. Amortization of capitalized commissions for the three and nine months ended September 30, 2019 was $0.3 million and $0.9 million, respectively. Disaggregation of Revenue The Company considered various factors for both its Clinical Services and Pharma Services segments in determining appropriate levels of homogeneous data for its disaggregation of revenue, including the nature, amount, timing and uncertainty of revenue and cash flows. For Clinical Services, the categories identified align with our type of customer due to similarities of billing method, level of reimbursement and timing of cash receipts. Unbilled amounts are accrued and allocated to payor categories based on historical experience. In future periods, actual billings by payor category may differ from accrued amounts. Pharma Services revenue was not further disaggregated as substantially all of our revenue relates to contracts with large pharmaceutical and biotech customers as well as other CROs for which the nature, timing and uncertainty of revenue and cash flows is similar and primarily driven by individual contract terms. The following table details the disaggregation of revenue for both the Clinical and Pharma Services Segments (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Clinical Services: Client direct billing $ 53,555 $ 39,779 $ 155,999 $ 120,925 Commercial Insurance 20,956 10,253 63,052 28,726 Medicare and Medicaid 17,818 8,603 47,961 25,333 Self-Pay 236 814 745 976 Total Clinical Services $ 92,565 $ 59,449 $ 267,757 $ 175,960 Pharma Services: 12,107 9,647 34,205 24,306 Total Revenue $ 104,672 $ 69,096 $ 301,962 $ 200,266

Acquisition

Acquisition	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
Acquisition	Acquisition On December 10, 2018 (the “Acquisition Date”), the Company acquired all of the issued and outstanding shares of common stock of Genesis Acquisition Holding Corp (“Genesis”), and its wholly owned subsidiary, Genoptix, Inc. (“Genoptix”, and collectively with its subsidiaries and Genesis, referred to herein as “Genoptix”), for a purchase price consisting of (i) cash consideration of approximately $127.0 million, which included approximately $2.0 million in estimated working capital adjustments and adjustments for estimated cash on hand of Genoptix on the Closing Date and (ii) 1.0 million shares of NeoGenomics’ common stock pursuant to an Agreement and Plan of Merger dated October 23, 2018 (the “Merger Agreement”). Cartesian Medical Group, Inc. (“Cartesian”) is a California professional corporation that provided hematopathology and other pathology services to Genoptix as an independent contractor. Cartesian was consolidated into Genoptix as a variable interest entity. Subsequent to December 31, 2018, the professional services agreement between Genoptix and Cartesian was terminated and the Company entered into separate medical services agreements with the entities owned by the physicians who were previously employees of Cartesian. The termination of the agreement with Cartesian did not have any impact on the Company’s consolidated financial statements. The Company issued approximately 1.0 million shares of common stock as consideration for the acquisition of Genoptix. This common stock was issued as unregistered shares, which carries a minimum six-month holding period before they may be sold to the public. The fair value of the common stock consideration was estimated using inputs not observable in the market and thus represents a Level 3 measurement. The key assumption in the fair value determination was a 5 percent discount due to lack of marketability of the common stock as a result of the restrictions imposed on the holder. The acquisition date fair value of common stock transferred is calculated below (in thousands, except share and per share amounts): Common Stock Valuation Amount Shares of common stock issued as consideration 1,000,000 Stock price per share on closing date $ 13.94 Value of common stock issued as consideration $ 13,940 Issue discount due to lack of marketability $ (697) Fair value of common stock at December 10, 2018 $ 13,243 The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Acquisition Date and measurement period and other adjustments recorded during 2019. Included in the measurement period and other adjustments is a $2.4 million working capital adjustment to the original cash consideration, as defined within the Merger Agreement, of which $0.4 million was received in cash with the remainder received as a return of common stock. The Company is in the process of completing its valuation of certain assets and liabilities, primarily related to accounts receivable and accounts payable assumed; thus, the provisional measurements of current assets and current liabilities are subject to change. December 10, 2018 Measurement Period and Other Adjustments December 10, 2018 Current assets $ 22,172 $ 2,257 $ 24,429 Property and equipment 21,029 (428) 20,601 Identifiable intangible assets 71,792 (3,463) 68,329 Goodwill 50,873 679 51,552 Long-term assets 170 — 170 Total assets acquired $ 166,036 $ (955) $ 165,081 Current liabilities (10,769) (892) (11,661) Long-term liabilities (1) (15,265) 282 (14,983) Net assets acquired $ 140,002 $ (1,565) $ 138,437 (1) Includes $14.7 million and $12.9 million as initially reported and as adjusted, respectively, in deferred tax liabilities associated with tangible and intangible assets acquired. Of the $68.3 million of acquired intangible assets, $54.2 million was provisionally assigned to customer relationships which are amortized over fifteen years, $0.7 million was provisionally assigned to the Genoptix trade name which is being amortized over one year, and $13.4 million was provisionally assigned to trade marks which are assigned as indefinite-lived assets. The goodwill arising from the acquisition of Genoptix includes revenue synergies as a result of our existing customers and Genoptix' customers having access to each other’s testing menus and capabilities and also from the new product lines, which Genoptix adds to the Company’s product portfolio, including the use of COMPASS and CHART trade names. None of the goodwill is expected to be deductible for income tax purposes. The provisional fair value of accounts receivable acquired is approximately $16.6 million, net of a $1.5 million fair value adjustment. The following unaudited pro forma information (in thousands) have been provided for illustrative purposes only and are not necessarily indicative of results that would have occurred had the acquisition of Genoptix occurred on January 1, 2018, nor are they necessarily indicative of future results. Nine Months Ended September 30, 2018 Revenue $ 274,609 Net loss $ (1,164) Net income available to common shareholders $ 2,284 The unaudited pro forma consolidated results have been prepared by adjusting our historical results to include the acquisition of Genoptix as if it occurred on January 1, 2018. These unaudited pro forma consolidated historical results were then adjusted for

Goodwill and Intangible Assets

Goodwill and Intangible Assets	9 Months Ended
	Sep. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill as of September 30, 2019 and December 31, 2018 was $198.6 million and $197.9 million, respectively. In 2019, the Company recorded measurement period and other adjustments of $0.7 million. Refer to Note E, Acquisition, herein for further detail. Intangible assets consisted of the following as of (in thousands): September 30, 2019 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,679 $ 3,552 $ 127 Non-Compete Agreement 24 months 27 27 — Customer Relationships 180 months 139,271 23,761 115,510 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,424 $ 27,340 $ 129,084 December 31, 2018 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,675 $ 3,042 $ 633 Non-Compete Agreement 24 months 27 18 9 Customer Relationships 180 months 141,626 16,798 124,828 Trade Name - Indefinite-lived — 14,559 — 14,559 Total $ 159,887 $ 19,858 $ 140,029 The Company recorded approximately $2.4 million and $1.4 million in straight-line amortization expense of intangible assets for the three months ended September 30, 2019 and 2018, respectively, and approximately $7.5 million and $4.3 million for the nine months ended September 30, 2019 and 2018, respectively. The Company records amortization expense as a general and administrative expense. The estimated amortization expense related to amortizable intangible assets for each of the four succeeding fiscal years and thereafter as of September 30, 2019 is as follows (in thousands): Remainder of 2019 $ 2,448 2020 9,285 2021 9,285 2022 9,285 2023 9,285 Thereafter 76,049 Total $ 115,637

Debt

Debt	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
Debt	Debt The following table summarizes the long term debt, net at September 30, 2019 and December 31, 2018 (in thousands): September 30, 2019 December 31, 2018 Term loan $ 100,000 $ 96,750 Revolving credit facility — 5,000 Financing obligations 9,732 11,548 Total debt $ 109,732 $ 113,298 Less: Debt issuance costs (723) (997) Less: Current portion of long-term debt and financing obligations (12,000) (14,171) Total long-term debt, net $ 97,009 $ 98,130 The carrying value of the Company’s term loan and financing obligations approximates fair value based on the current market conditions for similar instruments. Senior Secured Credit Agreement On June 27, 2019 (the “Closing Date”), the Company entered into a new senior secured credit agreement (the “New Credit Agreement”) with PNC Bank National Association (“PNC”), as administrative agent, and the lenders party thereto. The New Credit Agreement provides for a $100.0 million revolving credit facility (the “Revolving Credit Facility”), a $100.0 million term loan facility (the “Term Loan Facility”), and a $50.0 million delayed draw term loan which has an availability period beginning on the Closing Date and ending on December 27, 2020 (the “Delayed Draw Term Loan”). The Term Loan Facility and amounts borrowed under the Revolving Credit Facility are secured on a first priority basis by a security interest in substantially all of the tangible and intangible assets of the Company. Borrowings under the New Credit Agreement bear interest at a rate per annum equal to an applicable margin plus, at the Company’s option, either (1) the Adjusted LIBOR rate for the relevant interest period, as defined within the agreement (2) an alternate base rate determined by reference to the greatest of (a) the federal funds rate for the relevant interest period plus 0.5% per annum, (b) the prime lending rate of PNC and (c) the daily LIBOR rate plus 1% per annum, or (3) a combination of (1) and (2). The applicable margin will range from 1.25% to 2.25% for LIBOR loans and 0.25% to 1.25% for base rate loans, in each case based on NeoGenomics’ Consolidated Leverage Ratio (as defined in the New Credit Agreement). Interest on borrowings under the New Credit Agreement is payable on the last day of each month, in the case of each base rate loan, and on the last day of each interest period (but no less frequently than every three months), in the case of LIBOR loans. The Company has previously entered into interest rate swap agreements to hedge against changes in the variable rate for a portion of our long term debt. See Note H, Derivative Instruments and Hedging Activities, for more information on these instruments. The Revolving Credit Facility includes a $10.0 million swing loan sublimit, with swing loans bearing interest at the alternate base rate plus the applicable margin. Any principal outstanding under the Revolving Credit Facility is due and payable on June 27, 2024 or such earlier date as the obligations under the New Credit Agreement become due and payable pursuant to the terms of the New Credit Agreement. No amounts were outstanding under Revolving Credit Facility as of September 30, 2019. Principal payments on the Term Loan Facility will be due on the last day of each fiscal quarter beginning September 30, 2019, with an annual principal amortization of 5% in the first year, 5% in the second year, 7.5% in the third year, 7.5% in the fourth year, and 10% in each year thereafter, with the remainder due upon maturity on June 27, 2024 or such earlier date as the obligations under the New Credit Agreement become due and payable pursuant to the terms of the New Credit Agreement. On September 30, 2019, the Company had current outstanding borrowings under the Term Loan Facility of approximately $6.3 million, and long-term outstanding borrowings of approximately $93.7 million, net of unamortized debt issuance costs of $0.7 million. These costs were recorded as a reduction in the carrying amount of the related liability and are being amortized over the life of the loan. In addition to paying interest on outstanding principal under the New Credit Agreement, the Company will be required to pay a commitment fee in respect of the unutilized portion of the commitments under the Revolving Credit Facility and the Delayed Draw Term Loan. The commitment fee rate will initially be 0.25% per annum, and, beginning in the fourth quarter of 2019, will range from 0.15% to 0.35% depending on NeoGenomics’ Consolidated Leverage Ratio. The Company will also pay customary letter of credit and agency fees. The Term Loan Facility contains various covenants including entering into certain indebtedness; ability to incur liens and encumbrances; make certain restricted payments, including paying dividends on its equity securities or payments to redeem, repurchase or retire its equity securities; enter into certain burdensome agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into certain sale and leaseback transactions; engage in transactions with its affiliates, and materially alter the business it conducts. In addition, the Company must meet certain maximum leverage ratios and fixed charge coverage ratios as of the end of each fiscal quarter. The Term Loan Facility requires the Company to mandatorily prepay the Term Loan Facility and amounts borrowed under the Revolving Credit Facility with (i) 100% of net cash proceeds from certain sales and dispositions, subject to certain reinvestment rights, and (ii) 100% of net cash proceeds from certain issuances or incurrences of additional debt. Prior Financing Agreement Simultaneous with entering into the New Credit Agreement, on June 27, 2019, the Company terminated the Prior Financing Agreement and repaid all outstanding amounts owed thereunder. The Prior Financing Agreement, originally entered into on December 22, 2016, with Regions Bank as administrative agent and collateral agent, provided for a $75.0 million term loan facility (the “Prior Term Loan Facility”) and a $75.0 million revolving credit facility (the “Prior Revolving Credit Facility”). On June 21, 2018, the Company entered into an amendment to the Prior Credit Agreement (the “Amendment”) which provided for an additional term loan in the amount of $30.0 million, for which revised terms are included below. On December 31, 2018, the Company had current outstanding borrowings under the Prior Term Loan Facility, as amended, of approximately $7.9 million, and long-term outstanding borrowings of approximately $87.9 million, net of unamortized debt issuance costs of $1.0 million. During the fourth quarter of 2018, $5.0 million was drawn from the Prior Revolving Credit Facility, resulting in outstanding borrowings of $5.0 million as of December 31, 2018. The Prior Term Loan Facility and Prior Revolving Credit Facility were terminated on June 27, 2019. In association with the early termination of debt, the Company incurred a loss on the extinguishment of debt of $1.0 million. Borrowings under the Prior Term Loan Facility bore interest at a rate per annum equal to an applicable margin plus, at the Company’s option, either (1) the Adjusted LIBOR rate for the relevant interest period, as defined within the Credit Agreement, (2) an alternate base rate determined by reference to the greatest of (a) the prime lending rate of Regions, (b) the federal funds rate for the relevant interest period plus 0.5% per annum and (c) the one month LIBOR rate plus 1% per annum (the “Alternate Base Rate”), or (3) a combination of (1) and (2). The applicable margin ranged from 2.25% to 4.00% for LIBOR loans and 1.25% to 3.00% for base rate loans, in each case based on NeoGenomics’ consolidated leverage ratio (as defined in the Prior Financing Agreement and revised in the Amendment). Interest on borrowings was payable on the last day of each month, in the case of each base rate loan, and on the last day of each interest period (but no less frequently than every three months), in the case of Adjusted LIBOR loans. The Prior Revolving Credit Facility included a $10.0 million swing loan sublimit, with swingline loans bearing interest at the Alternate Base Rate plus the applicable margin. The Prior Term Loan Facility and amounts borrowed under the Prior Revolving Credit Facility were secured on a first priority basis by a security interest in substantially all of the tangible and intangible assets of the Company. The Prior Term Loan Facility contained various affirmative and negative covenants including ability to incur liens and encumbrances; make certain restricted payments, including paying dividends on its equity securities or payments to redeem, repurchase or retire its equity securities; enter into certain restrictive agreements; make investments, loans and acquisitions; merge or consolidate with any other person; dispose of assets; enter into sale and leaseback transactions; engage in transactions with its affiliates, and materially alter the business it conducts. In addition, the Company was required to meet certain maximum leverage ratios and fixed charge coverage ratios as of the end of each fiscal quarter. The Prior Financing Agreement required the Company to mandatorily prepay the Prior Term Loan Facility and amounts borrowed under the Prior Revolving Credit Facility with (i) 100% of net cash proceeds from certain sales and dispositions, subject to certain reinvestment rights, (ii) 100% of net cash proceeds from certain issuances or incurrences of additional debt, (iii) beginning with the fiscal year ended December 31, 2018, 75% of consolidated excess cash flow (as defined) if the Company’s consolidated leverage ratio was greater than or equal to 3.25:1.0 or 50% of consolidated excess cash flow (as defined) if the Company’s consolidated leverage ratio was less than or equal to 3.25:1.0 but greater than or equal to 2.75:1.0 and (iv) 100% of net cash proceeds from issuances of permitted equity securities by the Company made in order to cure a failure to comply with the financial covenants. Financing Obligations The Company has entered into loans with various banks to finance the purchase of laboratory equipment, office equipment and leasehold improvements. These loans mature at various dates through 2022 and the weighted average interest rate under such loans was approximately 4.67% as of September 30, 2019 and 4.56% as of December 31, 2018. Maturities of Long-Term Debt Maturities of long-term debt as of September 30, 2019 are summarized as follows (in thousands): Term Loan Financing Obligations Total Long-Term Debt Remainder of 2019 $ 2,500 $ 1,667 $ 4,167 2020 5,000 5,270 10,270 2021 6,250 2,455 8,705 2022 7,500 340 7,840 2023 8,750 — 8,750 2024 70,000 — 70,000 Total Debt 100,000 9,732 109,732 Less: Current portion of long-term debt (6,250) (5,750) (12,000) Less: Debt issuance costs (723) — (723) Long-term debt, net $ 93,027 $ 3,982 $ 97,009

Derivative Instruments and Hedg

Derivative Instruments and Hedging Activities	9 Months Ended
	Sep. 30, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities	Derivative Instruments and Hedging Activities In December of 2016 and June of 2018, the Company entered into interest rate swap agreements to reduce the Company ’ s exposure to interest rate fluctuations on the Company ’ s variable rate debt obligations. These derivative financial instruments are accounted for at fair value as cash flow hedges, which effectively modifies the Company’s exposure to interest rate risk by converting a portion of its floating rate debt to a fixed rate obligation, thus reducing the impact of interest rate changes on future interest expense. Under these hedging agreements, the Company receives a variable rate of interest based on LIBOR and we pay a fixed rate of interest. The following table summarizes the interest rate swap agreements. December 2016 Hedge June 2018 Hedge Notional Amount $50 million $20 million (1) Effective Date December 30, 2016 June 29, 2018 Index One month LIBOR One month LIBOR Maturity December 31, 2019 December 31, 2021 Fixed Rate 1.59 % 2.98 % (1) The notional amount increases to $70 million upon maturity of December 2016 hedge on December 31, 2019.

Class A Redeemable Convertible

Class A Redeemable Convertible Preferred Stock	9 Months Ended
	Sep. 30, 2019
Temporary Equity Disclosure [Abstract]
Class A Redeemable Convertible Preferred Stock	Class A Redeemable Convertible Preferred Stock On December 30, 2015, the Company issued 14,666,667 shares of its Series A Redeemable Convertible Preferred Stock ("Series A Preferred Stock") as part of the consideration for the acquisition of Clarient. The Series A Preferred Stock had a face value of $7.50 per share for a total liquidation value of $110 million. On December 22, 2016, the Company redeemed 8,066,667 shares of the Series A Preferred Stock for $55.0 million in cash. The redemption amount per share equaled $6.82 ($7.50 minus the liquidation discount of 9.09%). In December 2017, the Company issued 264,000 additional shares of preferred stock as a paid-in-kind dividend, resulting in a balance of 6,864,000 shares of Series A Preferred Stock outstanding at March 31, 2018. On June 25, 2018, the Company redeemed the remaining outstanding preferred stock for an aggregate redemption amount of $50.1 million, prior to consideration of any transaction related expenses. The shares were redeemed at $7.30 per share, representing the applicable 4.55% redemption discount on the original liquidation preference plus an additional $0.14 per share in respect of accrued and unpaid dividends for 2018. Following the redemption, no shares of preferred stock remain outstanding. The $9.1 million gain was calculated as the carrying value of the shares of preferred stock before the redemption of $37.8 million plus the amount of the beneficial conversion feature originally recorded with the redeemed shares of $21.3 million, as compared to the total consideration being paid, in this case the $50.1 million. Issue Discount The Company recorded the Series A Preferred Stock at a fair value of approximately $73.2 million, or $4.99 per share, on the date of issuance. The difference between the fair value of $73.2 million and the liquidation value of $110 million represents a discount of $36.8 million from the initial face value representing the impact the rights and features of the instrument had on the value to the Company. After the partial redemption, the Series A Preferred stock had a fair value of approximately $32.9 million, or $4.99 per share. The difference between the fair value of $32.9 million and the liquidation value of $49.5 million represented a discount of approximately $16.6 million. Beneficial Conversion Features (“BCF”) The fair value of the common stock into which the Series A Preferred Stock was convertible exceeded the allocated purchase price fair value of the Series A Preferred Stock at the date of issuance and after the partial redemption in December of 2016 by approximately $44.7 million and $20.1 million, respectively, resulting in a beneficial conversion feature. The Company recognized the beneficial conversion feature as non-cash, deemed dividends to the holder of Series A Preferred Stock over the first three years the Series A Preferred Stock was outstanding, as the date the stock first becomes convertible was three years from the issue date. In addition to the BCF recorded at the original issue date, the Company recorded additional BCF discounts for payment-in-kind shares accrued for the quarter ended March 31, 2018 as dividends. Classification

Equity

Equity	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Equity	Equity The Company recorded approximately $3.3 million and $1.1 million in stock based compensation expense for the three months ended September 30, 2019 and 2018, respectively, and approximately $7.7 million and $5.0 million in stock based compensation expense for the nine month periods ended September 30, 2019 and 2018, respectively. A summary of the stock option activity under the Company’s plans for the nine months ended September 30, 2019 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2018 6,839,417 $ 7.63 Options granted 943,345 $ 19.74 Less: Options exercised 1,439,869 $ 6.58 Options canceled or expired 174,927 $ 13.15 Options outstanding at September 30, 2019 6,167,966 $ 9.56 Exercisable at September 30, 2019 2,995,419 $ 7.20 The fair value of each stock option award granted during the nine months ended September 30, 2019 was estimated as of the grant date using a trinomial lattice model with the following weighted average assumptions: Nine Months Ended Expected term (in years) 3.0 - 4.5 Risk-free interest rate (%) 2.5% Expected volatility (%) 38.9% - 44.0% Dividend yield (%) — Weighted average fair value/share at grant date $5.76 As of September 30, 2019, there was approximately $5.7 million of unrecognized share based compensation expense related to stock options that will be recognized over a weighted-average period of approximately 1.37 years. A summary of the restricted stock activity under the Company’s plans for the nine months ended September 30, 2019 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2018 282,508 $ 9.01 Granted 227,188 $ 19.91 Vested (121,801) $ 9.60 Forfeited (51,389) $ 11.72 Nonvested at September 30, 2019 336,506 $ 15.75 Employee Stock Purchase Plan (ESPP) The Company offers an ESPP through which eligible employees may purchase shares of our common stock at a discount of 15% of the fair market value of the Company’s common stock. During the three months ended September 30, 2019 and 2018, employees purchased 28,672 and 21,100 shares, respectively under the ESPP. The expense recorded for these periods was approximately $0.1 million and $0.1 million, respectively. During the nine months ended September 30, 2019 and 2018, employees purchased 101,959 and 87,288 shares, respectively, under the ESPP. The expense recorded for these periods was approximately $0.4 million and $0.2 million, respectively. Working Capital Adjustment In the first quarter of 2019, the Company recorded a $2.4 million working capital adjustment to the original cash consideration, as defined within the Merger Agreement. In June 2019, the Company received the proceeds of the working capital adjustment as $0.4 million in cash with the remainder received as a return of 99,254 shares of common stock. Public Offering of Common Stock

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesTo calculate its interim tax provision, at the end of each interim period, the Company estimates the annual effective tax rate and applies such rate to its year-to-date ordinary earnings. The effect of changes in enacted tax laws or rates and excess tax benefits and tax deficiencies related to stock option exercises are recognized in the interim period in which the change occurs. In addition, the effect of significant, unusual, or infrequent items are recognized in the interim period in which the event occurs. The computation of the annual estimated effective tax rate at each interim period requires certain estimates and significant judgment including, but not limited to, the expected operating income for the year, projections of the proportion of income earned in foreign jurisdictions, permanent and temporary differences between book and tax amounts, and the likelihood of recovering deferred tax assets generated in the current year. The accounting estimates used to compute the provision for income taxes may change as new events occur, additional information is obtained or the tax environment changes.The income tax benefit for the nine months ended September 30, 2019 relates primarily to non-qualified stock option exercises, disqualified incentive stock option exercises, as well as a pre-tax loss incurred related to legal settlements, which includes the Health Discovery Corporation litigation (see Note L, Commitments and Contingencies) for which the income tax benefit was recognized within the quarter ended March 31, 2019. The Company’s effective tax rate was a benefit of 41.3% for the nine months ended September 30, 2019, differs from the federal statutory rate of 21% primarily due to tax deductions for equity compensation in excess of GAAP expense, offset by losses in foreign jurisdictions with no associated tax benefit and other non-deductible permanent differences.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments an Contingencies	Commitments and Contingencies Legal Matters The Company was involved in litigation with Health Discovery Corporation (“HDC”) regarding the use of certain licensed technology under a Master License Agreement (“MLA”) dated January 6, 2012 between the Company and HDC. An arbitration hearing took place in December 2018, where the Company vigorously defended its legal rights and remedies pertaining to this licensing dispute. On April 25, 2019, the American Arbitration Association’s Panel of Arbitrators (the “Panel”) issued their ruling (the “Final Award”) which, in pertinent part, terminated the MLA, awarded $1.5 million to HDC in connection with the claims that SmartFlow infringes a valid patent and that internal use by NeoGenomics was subject to milestone and royalty payments, and awarded $5.1 million to HDC with respect to the claim of lack of development and commercialization of SVM-CYTO. All other claims by HDC were denied. The Company’s request for a declaratory judgment was denied and its counterclaims were denied. The Company recorded an accrual of $4.9 million, net of tax, for this matter during the quarter ended March 31, 2019 and paid $6.7 million to HDC related to this matter in the quarter ended June 30, 2019 . This payment settled all obligations of the Company in connection with this litigation. The Company no longer utilizes any HDC technology.

Related Party Transactions

Related Party Transactions	9 Months Ended
	Sep. 30, 2019
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions On November 4, 2016, the Company entered into an amended and restated consulting agreement with Steven C. Jones, a director, officer and shareholder of the Company whereby Mr. Jones would provide consulting services to the Company in the capacity of Executive Vice President. The Amended and Restated Consulting Agreement has an initial term of November 4, 2016 through April 30, 2020, which automatically renews for additional one year periods unless either party provides notice of termination at least three months prior to the expiration of the initial term or any renewal term. On May 6, 2019, the Company and Mr. Jones entered into a letter agreement to modify certain provisions of the consulting agreement (the “Letter Agreement”) which modifications included, by mutual agreement of the parties, the following: automatic expiration of the consulting agreement on April 30, 2020 unless the parties mutually agree to renew it in writing; a description of consulting services to be provided to the Company (the “Services”) with a target of up to 15 hours per month of working time and attention to the Company; a fixed monthly cash consulting fee in the amount of $5,000 per month for the provision of the Services; and continuation of health insurance coverage at the levels currently in effect. In addition, Mr. Jones relinquished the title of Executive Vice President effective as of April 4, 2019. During the three months ended September 30, 2019 and 2018, Mr. Jones earned approximately $15,750 and $38,000, respectively, for consulting work performed and for reimbursement of related expenses. During the three months ended September 30, 2019 and 2018, Mr. Jones earned approximately $13,125 and $12,500, respectively, as compensation for his services on the Board. During the nine months ended September 30, 2019 and 2018, Mr. Jones earned approximately $76,250 and $125,000, respectively, for consulting work performed and for reimbursement of related expenses. During the nine months ended September 30, 2019 and 2018, Mr. Jones also earned $38,125 and $37,500, respectively, as compensation for his services on the Board. On June 1, 2018, the Company granted stock options and restricted stock to each of its Board members as part of its annual Board compensation process. Mr. Jones was granted 3,017 stock options and 6,897 shares of restricted stock for his services on the Board. The options were granted at a price of $11.60 per option and each option had a fair market value of $3.74. The options vested on June 1, 2019. The restricted stock had a fair value of $11.60 per share and vested on June 1, 2019. On June 6, 2019, the Company granted stock options and restricted stock to each of its Board members as part of its annual Board compensation process. Mr. Jones was granted 4,269 stock options and 3,419 shares of restricted stock for his services on the Board. The options were granted at a price of $22.52 per option and each option had a fair market value of $8.14. The options vest on June 6, 2020. The restricted stock has a fair value of $22.52 per share and vests on June 6, 2020.

Segment Information

Segment Information	9 Months Ended
	Sep. 30, 2019
Segment Reporting [Abstract]
Segment Information	Segment Information The Company has two operating segments for which it recognizes revenue; Clinical Services and Pharma Services. Our Clinical Services segment provides various clinical testing services to community-based pathology practices, hospital pathology labs and academic centers with reimbursement from various payers including client direct billing, commercial insurance, Medicare and other government payers, and patients. Our Pharma Services segment supports pharmaceutical firms in their drug development programs by supporting various clinical trials and research. The financial information reviewed by the Chief Operating Decision Maker (“CODM”) includes revenues, cost of revenue and gross margin for each of the Company’s operating segments. Assets are not presented at the segment level as that information is not used by the CODM. The following table summarizes the segment information (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Net revenues: Clinical Services $ 92,565 $ 59,449 $ 267,757 $ 175,960 Pharma Services 12,107 9,647 34,205 24,306 Total Revenue 104,672 69,096 301,962 200,266 Cost of revenue: Clinical Services 47,526 31,509 136,557 94,586 Pharma Services 6,314 5,266 18,492 15,525 Total Cost of Revenue 53,840 36,775 155,049 110,111 Gross Profit: Clinical Services 45,039 27,940 131,200 81,374 Pharma Services 5,793 4,381 15,713 8,781 Total Gross Profit 50,832 32,321 146,913 90,155 Operating expenses: 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 — — 1,018 — Income before taxes 3,491 2,077 1,210 2,422 Income tax expense (benefit) 1,348 54 (500) 135 Net income $ 2,143 $ 2,023 $ 1,710 $ 2,287

Nature of Business and Basis _2

Nature of Business and Basis of Presentation (Tables)	9 Months Ended
	Sep. 30, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule of Error Corrections and Prior Period Adjustments	The following table shows the amounts of additional paid-in capital, accumulated deficit, deemed dividends on preferred stock and amortization of beneficial conversion feature, and gain on redemption of preferred stock for the applicable periods, as previously reported and as corrected in the consolidated statements of redeemable preferred stock and stockholders' equity and balance sheets (in thousands): As Previously Reported As Corrected Additional Paid-in Capital Accumulated Deficit Additional Paid-in Capital Accumulated Deficit Balance at December 31, 2017 $ 230,030 $ (58,422) $ 194,687 $ (23,079) Deemed dividends on preferred stock and amortization of beneficial conversion feature — (2,856) (2,856) — Balance at March 31, 2018 232,039 (60,634) 193,840 (22,435) Deemed dividends on preferred stock and amortization of beneficial conversion feature* 419 (2,771) (2,352) — Gain on redemption of preferred stock — 9,075 9,075 — Balance at June 30, 2018 217,451 (53,580) 185,556 (21,685) Balance at September 30, 2018 354,487 (51,557) 322,592 (19,662) Balance at December 31, 2018 372,186 (51,258) 340,291 (19,363) Balance at March 31, 2019 378,571 (53,682) 346,676 (21,787) Balance at June 30, 2019 $ 543,484 $ (51,691) $ 511,589 $ (19,796) *The deemed dividends on preferred stock and amortization of beneficial conversion feature within additional paid-in capital as previously reported as shown here reflects a $21.3 million reclassification to the redemption of Series A preferred stock within additional paid-in capital. As discussed above, such presentation reclassifications have no impact to total paid-in capital for any period. The following table shows the amounts of the redemption of preferred stock, deemed dividends on preferred stock and amortization of beneficial conversion feature, and gain on redemption of preferred stock for the applicable periods, as previously reported and as currently reported in the consolidated statements of redeemable preferred stock and stockholders' equity (in thousands): As Previously Reported As Currently Reported Series A Redeemable Convertible Preferred Stock Immaterial Correction of an Error Reclassification Series A Redeemable Convertible Preferred Stock Balance at March 31, 2018 $ 35,471 $ — $ — $ 35,471 Redemption of Series A Preferred Stock (50,096) — 12,273 (37,823) Deemed dividends on preferred stock and amortization of beneficial conversion feature 5,550 18,150 (21,348) 2,352 Gain on redemption of preferred stock 9,075 (18,150) 9,075 — Balance at June 30, 2018 $ — $ — $ — $ —

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Schedule of Future Minimum Lease Payments under Topic 842	As of September 30, 2019, the maturities of our operating lease liabilities and a reconciliation to the present value of lease liabilities were as follows (in thousands): Remaining Lease Payments Remainder of 2019 $ 1,540 2020 4,969 2021 5,050 2022 4,213 2023 4,076 2024 4,097 Thereafter 12,705 Total remaining lease payments 36,650 Less: imputed interest (9,253) Total operating lease liabilities 27,397 Less: current portion (3,527) Long-term operating lease liabilities $ 23,870 Weighted-average remaining lease term (in years) 8.1 Weighted-average discount rate 6.5 %
Supplemental Operating Lease Information	The following summarizes additional supplemental data related to our operating leases (in thousands): Three Months Ended Nine Months Ended Operating lease costs $ 1,271 $ 4,365 Nine Months Ended Right-of-use assets obtained in exchange for operating lease liabilities $ 19,341
Schedule of Future Minimum Lease Payments under Topic 840	As previously disclosed in our 2018 Annual Report on Form 10-K and under the previous lease accounting standard, future minimum lease payments for operating leases having initial or remaining noncancellable lease terms in excess of one year were as follows (in thousands): Years ending December 31, 2019 $ 5,247 2020 2,798 2021 1,082 2022 453 2023 92 Thereafter — Total minimum lease payments $ 9,672

Revenue Recognition and Contr_2

Revenue Recognition and Contractual Adjustments (Tables)	9 Months Ended
	Sep. 30, 2019
Revenue from Contract with Customer [Abstract]
Summary of Contract Assets and Liabilities	The following table summarizes the values of contract assets, capitalized commissions and contract liabilities (in thousands): September 30, 2019 December 31, 2018 Current pharma contract assets (1) $ 234 $ 86 Long-term pharma contract assets (2) 627 268 Total pharma contract assets $ 861 $ 354 Current pharma capitalized commissions (1) $ 222 $ 271 Long-term pharma capitalized commissions (2) 839 650 Total pharma capitalized commissions $ 1,061 $ 921 Current pharma contract liabilities $ 1,187 $ 927 Long-term pharma contract liabilities (3) 1,898 1,652 Total pharma contract liabilities $ 3,085 $ 2,579 (1) Current pharma contract assets and Current pharma capitalized commissions are classified as “Other current assets” on the Consolidated Balance Sheets. (2) Long-term pharma contract assets and Long-term pharma capitalized commissions are classified as “Other assets” on the Consolidated Balance Sheets.
Summary of Disaggregation of Revenue	The following table details the disaggregation of revenue for both the Clinical and Pharma Services Segments (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2019 2018 2019 2018 Clinical Services: Client direct billing $ 53,555 $ 39,779 $ 155,999 $ 120,925 Commercial Insurance 20,956 10,253 63,052 28,726 Medicare and Medicaid 17,818 8,603 47,961 25,333 Self-Pay 236 814 745 976 Total Clinical Services $ 92,565 $ 59,449 $ 267,757 $ 175,960 Pharma Services: 12,107 9,647 34,205 24,306 Total Revenue $ 104,672 $ 69,096 $ 301,962 $ 200,266

Acquisition (Tables)

Acquisition (Tables)	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
Schedule of Business Acquisitions by Acquisition, Equity Interest Issued or Issuable	The acquisition date fair value of common stock transferred is calculated below (in thousands, except share and per share amounts): Common Stock Valuation Amount Shares of common stock issued as consideration 1,000,000 Stock price per share on closing date $ 13.94 Value of common stock issued as consideration $ 13,940 Issue discount due to lack of marketability $ (697) Fair value of common stock at December 10, 2018 $ 13,243
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The Company is in the process of completing its valuation of certain assets and liabilities, primarily related to accounts receivable and accounts payable assumed; thus, the provisional measurements of current assets and current liabilities are subject to change. December 10, 2018 Measurement Period and Other Adjustments December 10, 2018 Current assets $ 22,172 $ 2,257 $ 24,429 Property and equipment 21,029 (428) 20,601 Identifiable intangible assets 71,792 (3,463) 68,329 Goodwill 50,873 679 51,552 Long-term assets 170 — 170 Total assets acquired $ 166,036 $ (955) $ 165,081 Current liabilities (10,769) (892) (11,661) Long-term liabilities (1) (15,265) 282 (14,983) Net assets acquired $ 140,002 $ (1,565) $ 138,437
Business Acquisition, Pro Forma Information	The following unaudited pro forma information (in thousands) have been provided for illustrative purposes only and are not necessarily indicative of results that would have occurred had the acquisition of Genoptix occurred on January 1, 2018, nor are they necessarily indicative of future results. Nine Months Ended September 30, 2018 Revenue $ 274,609 Net loss $ (1,164) Net income available to common shareholders $ 2,284

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Classes of Intangible Assets	Intangible assets consisted of the following as of (in thousands): September 30, 2019 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,679 $ 3,552 $ 127 Non-Compete Agreement 24 months 27 27 — Customer Relationships 180 months 139,271 23,761 115,510 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,424 $ 27,340 $ 129,084 December 31, 2018 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,675 $ 3,042 $ 633 Non-Compete Agreement 24 months 27 18 9 Customer Relationships 180 months 141,626 16,798 124,828 Trade Name - Indefinite-lived — 14,559 — 14,559 Total $ 159,887 $ 19,858 $ 140,029
Estimated Amortization Expense	The estimated amortization expense related to amortizable intangible assets for each of the four succeeding fiscal years and thereafter as of September 30, 2019 is as follows (in thousands): Remainder of 2019 $ 2,448 2020 9,285 2021 9,285 2022 9,285 2023 9,285 Thereafter 76,049 Total $ 115,637

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
Summary of Long Term Debt	The following table summarizes the long term debt, net at September 30, 2019 and December 31, 2018 (in thousands): September 30, 2019 December 31, 2018 Term loan $ 100,000 $ 96,750 Revolving credit facility — 5,000 Financing obligations 9,732 11,548 Total debt $ 109,732 $ 113,298 Less: Debt issuance costs (723) (997) Less: Current portion of long-term debt and financing obligations (12,000) (14,171) Total long-term debt, net $ 97,009 $ 98,130
Summary of Maturities of Long-Term Debt	Maturities of long-term debt as of September 30, 2019 are summarized as follows (in thousands): Term Loan Financing Obligations Total Long-Term Debt Remainder of 2019 $ 2,500 $ 1,667 $ 4,167 2020 5,000 5,270 10,270 2021 6,250 2,455 8,705 2022 7,500 340 7,840 2023 8,750 — 8,750 2024 70,000 — 70,000 Total Debt 100,000 9,732 109,732 Less: Current portion of long-term debt (6,250) (5,750) (12,000) Less: Debt issuance costs (723) — (723) Long-term debt, net $ 93,027 $ 3,982 $ 97,009

Derivative Instruments and He_2

Derivative Instruments and Hedging Activities (Tables)	9 Months Ended
	Sep. 30, 2019
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Interest Rate Derivative Instruments	The following table summarizes the interest rate swap agreements. December 2016 Hedge June 2018 Hedge Notional Amount $50 million $20 million (1) Effective Date December 30, 2016 June 29, 2018 Index One month LIBOR One month LIBOR Maturity December 31, 2019 December 31, 2021 Fixed Rate 1.59 % 2.98 % (1) The notional amount increases to $70 million upon maturity of December 2016 hedge on December 31, 2019.

Equity (Tables)

Equity (Tables)	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Summary of Stock Option Activity	A summary of the stock option activity under the Company’s plans for the nine months ended September 30, 2019 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2018 6,839,417 $ 7.63 Options granted 943,345 $ 19.74 Less: Options exercised 1,439,869 $ 6.58 Options canceled or expired 174,927 $ 13.15 Options outstanding at September 30, 2019 6,167,966 $ 9.56 Exercisable at September 30, 2019 2,995,419 $ 7.20
Summary of Fair Value of Each Stock Option Award Granted	The fair value of each stock option award granted during the nine months ended September 30, 2019 was estimated as of the grant date using a trinomial lattice model with the following weighted average assumptions: Nine Months Ended Expected term (in years) 3.0 - 4.5 Risk-free interest rate (%) 2.5% Expected volatility (%) 38.9% - 44.0% Dividend yield (%) — Weighted average fair value/share at grant date $5.76
Summary of Restricted Stock Activity	A summary of the restricted stock activity under the Company’s plans for the nine months ended September 30, 2019 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2018 282,508 $ 9.01 Granted 227,188 $ 19.91 Vested (121,801) $ 9.60 Forfeited (51,389) $ 11.72 Nonvested at September 30, 2019 336,506 $ 15.75

Segment Information (Tables)

Segment Information (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2019 2018 2019 2018 Net revenues: Clinical Services $ 92,565 $ 59,449 $ 267,757 $ 175,960 Pharma Services 12,107 9,647 34,205 24,306 Total Revenue 104,672 69,096 301,962 200,266 Cost of revenue: Clinical Services 47,526 31,509 136,557 94,586 Pharma Services 6,314 5,266 18,492 15,525 Total Cost of Revenue 53,840 36,775 155,049 110,111 Gross Profit: Clinical Services 45,039 27,940 131,200 81,374 Pharma Services 5,793 4,381 15,713 8,781 Total Gross Profit 50,832 32,321 146,913 90,155 Operating expenses: 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 — — 1,018 — Income before taxes 3,491 2,077 1,210 2,422 Income tax expense (benefit) 1,348 54 (500) 135 Net income $ 2,143 $ 2,023 $ 1,710 $ 2,287

Nature of Business and Basis _3

Nature of Business and Basis of Presentation - Narrative (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Jun. 30, 2018USD ($)	Sep. 30, 2019segment	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Number of operating segments | segment		2
Percentage of consolidated assets net revenues and net income reported by reportable operating segment			100.00%
Stock Redeemed or Called During Period, Value | $	$ 21,348

Nature of Business and Basis _4

Nature of Business and Basis of Presentation - Schedule of Error Corrections (Details) - USD ($) $ in Thousands	Jun. 24, 2018	Sep. 30, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accumulated deficit		$ 497,007	$ 303,559	$ 164,209	$ 171,985	$ 497,007	$ 303,559	$ 489,734	$ 323,848	$ 320,443	$ 171,962
Deemed dividends on preferred stock and amortization of beneficial conversion feature				(2,352)	(2,856)
Redeemable preferred stock					35,471
Redemption of Series A Preferred Stock				(21,348)
Gain on redemption of preferred stock		0	0	9,075		0	9,075
Series A Redeemable Convertible Preferred Stock
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Deemed dividends on preferred stock and amortization of beneficial conversion feature				2,352	2,856
Redeemable preferred stock		0	0	0	35,471	0	0	0	0	0	32,615
Redemption of Series A Preferred Stock				(37,823)
Gain on redemption of preferred stock	$ 9,100			0
Series A Redeemable Convertible Preferred Stock | Previously Reported
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Deemed dividends on preferred stock and amortization of beneficial conversion feature				5,550
Redeemable preferred stock					35,471
Redemption of Series A Preferred Stock				(50,096)
Gain on redemption of preferred stock				9,075
Series A Redeemable Convertible Preferred Stock | Immaterial Correction of an Error
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Deemed dividends on preferred stock and amortization of beneficial conversion feature				18,150
Gain on redemption of preferred stock				(18,150)
Series A Redeemable Convertible Preferred Stock | Reclassification
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Deemed dividends on preferred stock and amortization of beneficial conversion feature				(21,348)
Redemption of Series A Preferred Stock				12,273
Gain on redemption of preferred stock				9,075
Additional Paid-in Capital
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accumulated deficit		516,936	322,592	185,556	193,840	516,936	322,592	511,589	346,676	340,291	194,687
Deemed dividends on preferred stock and amortization of beneficial conversion feature				(2,352)	(2,856)
Redemption of Series A Preferred Stock				(21,348)	(21,300)
Gain on redemption of preferred stock				9,075
Additional Paid-in Capital | Previously Reported
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accumulated deficit			354,487	217,451	232,039		354,487	543,484	378,571	372,186	230,030
Deemed dividends on preferred stock and amortization of beneficial conversion feature				419
Accumulated Deficit
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accumulated deficit		$ (17,653)	(19,662)	(21,685)	(22,435)	$ (17,653)	(19,662)	(19,796)	(21,787)	(19,363)	(23,079)
Accumulated Deficit | Previously Reported
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Accumulated deficit			$ (51,557)	(53,580)	(60,634)		$ (51,557)	$ (51,691)	$ (53,682)	$ (51,258)	$ (58,422)
Deemed dividends on preferred stock and amortization of beneficial conversion feature				(2,771)	$ (2,856)
Gain on redemption of preferred stock				$ 9,075

Recently Adopted and Issued A_2

Recently Adopted and Issued Accounting Guidance - Narrative (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Jan. 01, 2019
Accounting Changes and Error Corrections [Abstract]
Operating lease right-of-use assets	$ 25,797	$ 9,700
Operating lease liability	$ 27,397	$ 10,100

Leases - Narrative (Details)

Leases - Narrative (Details) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Lessee, Lease, Description [Line Items]
Operating lease, weighted average remaining lease term	8 years 1 month 6 days
Minimum lease payments for leases executed but not yet commenced	$ 50.3
Florida
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	$ 25
Minimum
Lessee, Lease, Description [Line Items]
Operating lease, weighted average remaining lease term	1 year
Lease renewal term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Operating lease, weighted average remaining lease term	10 years
Lease renewal term	5 years

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Jan. 01, 2019
Leases [Abstract]
Remainder of 2019	$ 1,540
2020	4,969
2021	5,050
2022	4,213
2023	4,076
2024	4,097
Thereafter	12,705
Total remaining lease payments	36,650
Less: imputed interest	(9,253)
Operating Lease, Liability, Total	27,397	$ 10,100
Less: current portion	(3,527)
Long-term portion of operating leases	$ 23,870
Operating lease, weighted average remaining lease term	8 years 1 month 6 days
Operating lease, weighted average discount rate (as a percent)	6.50%

Leases - Summary of Supplementa

Leases - Summary of Supplemental Lease Information (Details) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Leases [Abstract]
Operating lease cost	$ 1,271	$ 4,365
Right of use asset obtained in exchange for operating lease liabilities		$ 19,341

Leases - Schedule of Future M_2

Leases - Schedule of Future Minimum Lease Payments Under Previous Guidance (Details) $ in Thousands	Dec. 31, 2018USD ($)
Leases [Abstract]
2019	$ 5,247
2020	2,798
2021	1,082
2022	453
2023	92
Thereafter	0
Total minimum lease payments	$ 9,672

Revenue Recognition and Contr_3

Revenue Recognition and Contractual Adjustments - Narrative (Details) $ in Thousands	3 Months Ended	9 Months Ended
	Sep. 30, 2019USD ($)	Sep. 30, 2019USD ($)segment	Dec. 31, 2018USD ($)
Disaggregation of Revenue [Line Items]
Number of operating segments | segment		2
Increase in Pharma contract assets		$ 500
Pharma contract asset, increase (as a percent)	143.00%	143.00%
Increase in pharma contract liabilities		$ 500
Increase in pharma contract liabilities (as a percent)		20.00%
Capitalized contract costs	$ 1,061	$ 1,061	$ 921
Pharma contract liability, revenue recognized	100	2,000
Amortization of contract commissions	300	900
Commissions
Disaggregation of Revenue [Line Items]
Capitalized contract costs	$ 100	$ 100
Capitalized contract costs (as a percent)	15.00%	15.00%

Revenue Recognition and Contr_4

Revenue Recognition and Contractual Adjustments - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Contract with Customer, Asset, Net [Abstract]
Current pharma contract assets	$ 234	$ 86
Long-term pharma contract assets	627	268
Total pharma contract assets	861	354
Capitalized Contract Cost [Abstract]
Current pharma capitalized commissions	222	271
Long-term pharma capitalized commissions	839	650
Total pharma capitalized commissions	1,061	921
Contract with Customer, Liability [Abstract]
Current pharma contract liabilities	1,187	927
Long-term pharma contract liabilities	1,898	1,652
Total pharma contract liabilities	$ 3,085	$ 2,579

Revenue Recognition and Contr_5

Revenue Recognition and Contractual Adjustments - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	$ 104,672	$ 69,096	$ 301,962	$ 200,266
Clinical Services
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	92,565	59,449	267,757	175,960
Clinical Services | Client direct billing
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	53,555	39,779	155,999	120,925
Clinical Services | Commercial Insurance
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	20,956	10,253	63,052	28,726
Clinical Services | Medicare and Medicaid
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	17,818	8,603	47,961	25,333
Clinical Services | Self-Pay
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	236	814	745	976
Pharma Services
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	$ 12,107	$ 9,647	$ 34,205	$ 24,306

Acquisition - Narrative (Detail

Acquisition - Narrative (Details) - Genoptix - USD ($) $ in Thousands	Dec. 10, 2018	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2019
Business Acquisition [Line Items]
Payment for business acquisition	$ 127,000
Payment for working capital adjustments	$ 2,000		$ 2,400
Shares of common stock issued as consideration (in shares)	1,000,000
Payment for working capital adjustments, cash portion		$ 400
Identifiable intangible assets	$ 71,792			$ 68,329
Accounts receivable acquired				16,600
Accounts receivable, fair value adjustment				$ 1,500
Customer Relationships
Business Acquisition [Line Items]
Identifiable intangible assets	54,200
Trade Name
Business Acquisition [Line Items]
Identifiable intangible assets	700
Trademarks
Business Acquisition [Line Items]
Identifiable intangible assets	$ 13,400
Common Stock
Business Acquisition [Line Items]
Shares of common stock issued as consideration (in shares)	1,000,000

Acquisition - Schedule of Acqui

Acquisition - Schedule of Acquisition Date Fair Value (Details) - Genoptix $ / shares in Units, $ in Thousands	Dec. 10, 2018USD ($)$ / sharesshares
Business Acquisition [Line Items]
Shares of common stock issued as consideration (in shares) | shares	1,000,000
Stock price per share on closing date (in dollars per share) | $ / shares	$ 13.94
Value of common stock issued as consideration	$ 13,940
Issue discount due to lack of marketability	(697)
Fair value of common stock at December 10, 2018	$ 13,243

Acquisition - Schedule of Provi

Acquisition - Schedule of Provisional Information (Details) - USD ($) $ in Thousands	4 Months Ended	10 Months Ended
	Mar. 31, 2019	Sep. 30, 2019	Dec. 31, 2018	Dec. 10, 2018
Business Acquisition [Line Items]
Goodwill		$ 198,571	$ 197,892
Genoptix
Business Acquisition [Line Items]
Current assets		24,429		$ 22,172
Measurement period adjustments, current assets		2,257
Property and equipment		20,601		21,029
Measurement period adjustments, property and equipment		(428)
Identifiable intangible assets		68,329		71,792
Measurement period adjustments, identifiable intangible assets		(3,463)
Goodwill		51,552		50,873
Measurement period adjustments, goodwill		679
Long-term assets		170		170
Measurement period adjustments, long-term assets		0
Total assets acquired		165,081		166,036
Measurement period adjustments, total assets acquired		(955)
Current liabilities		(11,661)		(10,769)
Measurement period adjustments, current liabilities		(892)
Long-term liabilities		(14,983)		(15,265)
Measurement period adjustments, long-term liabilities		282
Net assets acquired		138,437		140,002
Measurement period adjustments, net assets acquired		$ (1,565)
Deferred tax liabilities				$ 14,700
Measurement period adjustments, deferred tax liabilities	$ 12,900

Acquisition - Pro Forma Informa

Acquisition - Pro Forma Information (Details) - Genoptix $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)
Business Acquisition [Line Items]
Revenue	$ 274,609
Net loss	(1,164)
Net income available to common shareholders	$ 2,284

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Narrative (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended		10 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Dec. 31, 2018	Dec. 10, 2018
Goodwill [Line Items]
Goodwill	$ 198,571		$ 198,571		$ 198,571	$ 197,892
Amortization of intangibles	2,400	$ 1,400	7,482	$ 4,255
Genoptix
Goodwill [Line Items]
Goodwill	$ 51,552		$ 51,552		51,552		$ 50,873
Measurement period adjustments, goodwill					$ 679

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Classes of Intangible Assets (Detail) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Total cost of intangibles	$ 156,424	$ 159,887
Accumulated Amortization	27,340	19,858
Finite-lived intangibles, net	115,637
Intangible assets, net	129,084	140,029
Trade Name
Finite-Lived Intangible Assets [Line Items]
Trade Name - Indefinite-lived	13,447	14,559
Trade Name
Finite-Lived Intangible Assets [Line Items]
Cost	3,679	3,675
Accumulated Amortization	3,552	3,042
Finite-lived intangibles, net	$ 127	$ 633
Non-Compete Agreement
Finite-Lived Intangible Assets [Line Items]
Amortization Period	24 months	24 months
Cost	$ 27	$ 27
Accumulated Amortization	27	18
Finite-lived intangibles, net	$ 0	$ 9
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period	180 months	180 months
Cost	$ 139,271	$ 141,626
Accumulated Amortization	23,761	16,798
Finite-lived intangibles, net	$ 115,510	$ 124,828
Minimum | Trade Name
Finite-Lived Intangible Assets [Line Items]
Amortization Period	12 months	12 months
Maximum | Trade Name
Finite-Lived Intangible Assets [Line Items]
Amortization Period	24 months	24 months

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Estimated Amortization Expense (Detail) $ in Thousands	Sep. 30, 2019USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Remainder of 2019	$ 2,448
2020	9,285
2021	9,285
2022	9,285
2023	9,285
Thereafter	76,049
Total	$ 115,637

Debt - Summary of Long Term Deb

Debt - Summary of Long Term Debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Financing obligations	$ 9,732	$ 11,548
Total debt	109,732	113,298
Less:  Debt issuance costs	(723)	(997)
Less:  Current portion of long-term debt and financing obligations	(12,000)	(14,171)
Long-term debt, net	97,009	98,130
Term Loan Facility
Debt Instrument [Line Items]
Long-term debt	100,000	96,750
Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt	$ 0	$ 5,000

Debt - Narrative (Detail)

Debt - Narrative (Detail) - USD ($)	Jun. 27, 2019	Sep. 30, 2019	Dec. 31, 2018	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Jun. 21, 2018	Dec. 22, 2016
Line of Credit Facility [Line Items]
Long-term outstanding borrowings		$ 0	$ 5,000,000		$ 0
Debt issuance costs		723,000	$ 997,000		723,000
Loss on extinguishment of debt		$ 0		$ 0	$ (1,018,000)	$ 0
Debt instrument, weighted average interest rates		4.67%	4.56%		4.67%
Revolving Credit Facility
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity								$ 75,000,000
Line of credit facility, swingline sublimit								10,000,000
Proceeds from issuance of debt			$ 5,000,000
Term Loan
Line of Credit Facility [Line Items]
Long-term outstanding borrowings			87,900,000
Debt instrument, percentage of net cash proceeds from sales and dispositions subject to certain reinvestment rights		100.00%			100.00%
Debt instrument, percentage of net cash proceeds from issuances or incurrence of additional debt to be used for mandatory prepayment		100.00%			100.00%
Debt Instrument, maximum borrowing capacity							$ 30,000,000	$ 75,000,000
Debt instrument, percentage of excess cash flow to be used for mandatory prepayment starting next fiscal year		75.00%			75.00%
Debt instrument covenant leverage ratio					325.00%
Debt instrument, step-down percentage		50.00%			50.00%
Debt instrument, percentage of net cash proceeds from issuances of permitted equity securities to be used for mandatory prepayment		100.00%			100.00%
Term Loan | Minimum
Line of Credit Facility [Line Items]
Debt instrument covenant leverage ratio					275.00%
Term Loan | Maximum
Line of Credit Facility [Line Items]
Debt instrument covenant leverage ratio					325.00%
Term Loan | Federal Funds Rate
Line of Credit Facility [Line Items]
Debt instrument variable interest rate					0.50%
Term Loan | LIBOR
Line of Credit Facility [Line Items]
Debt instrument variable interest rate					1.00%
Term Loan | LIBOR | Minimum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					2.25%
Term Loan | LIBOR | Maximum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					4.00%
Term Loan | Base Rate | Minimum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					1.25%
Term Loan | Base Rate | Maximum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					3.00%
New Credit Agreement | Federal Funds Rate
Line of Credit Facility [Line Items]
Debt instrument variable interest rate					0.50%
New Credit Agreement | LIBOR
Line of Credit Facility [Line Items]
Debt instrument variable interest rate					1.00%
New Credit Agreement | LIBOR | Minimum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					1.25%
New Credit Agreement | LIBOR | Maximum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					2.25%
New Credit Agreement | Base Rate | Minimum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					0.25%
New Credit Agreement | Base Rate | Maximum
Line of Credit Facility [Line Items]
Debt instrument applicable margin					1.25%
New Credit Agreement | Revolving Credit Facility
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity	$ 100,000,000
Line of credit facility, swingline sublimit	$ 10,000,000
Commitment fee (as a percent)	0.25%
New Credit Agreement | Revolving Credit Facility | Minimum
Line of Credit Facility [Line Items]
Commitment fee (as a percent)	0.15%
New Credit Agreement | Revolving Credit Facility | Maximum
Line of Credit Facility [Line Items]
Commitment fee (as a percent)	0.35%
New Credit Agreement | Term Loan
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity	$ 100,000,000
Annual principal amortization, year one (as a percent)	5.00%
Annual principal amortization, year two (as a percent)	5.00%
Annual principal amortization, year three (as a percent)	7.50%
Annual principal amortization, year four (as a percent)	7.50%
Annual principal amortization, thereafter (as a percent)	10.00%
Line of credit facility, outstanding borrowings		$ 6,300,000			$ 6,300,000
Long-term outstanding borrowings		93,700,000			93,700,000
Debt issuance costs		$ 700,000			$ 700,000
Debt instrument, percentage of net cash proceeds from sales and dispositions subject to certain reinvestment rights		100.00%			100.00%
Debt instrument, percentage of net cash proceeds from issuances or incurrence of additional debt to be used for mandatory prepayment		100.00%			100.00%
New Credit Agreement | Delayed Draw Term Loan
Line of Credit Facility [Line Items]
Line of credit facility maximum borrowing capacity	$ 50,000,000
Prior Financing Agreement
Line of Credit Facility [Line Items]
Loss on extinguishment of debt		$ 1,000,000
Prior Financing Agreement | Revolving Credit Facility
Line of Credit Facility [Line Items]
Line of credit facility, outstanding borrowings			5,000,000
Prior Financing Agreement | Term Loan
Line of Credit Facility [Line Items]
Line of credit facility, outstanding borrowings			$ 7,900,000

Debt - Schedule of Maturities o

Debt - Schedule of Maturities of Long Term Debt (Detail) - USD ($) $ in Thousands	Sep. 30, 2019	Dec. 31, 2018
Long-term Debt, by Current and Noncurrent [Abstract]
Less:  Debt issuance costs	$ (723)	$ (997)
Finance Obligations
Less: Current portion of long-term debt	(5,750)
Long-term portion of finance lease obligations	3,982
Total Long-Term Debt
2019	4,167
2020	10,270
2021	8,705
2022	7,840
2023	8,750
2024	70,000
Long-term debt and finance obligations, including current maturities	109,732
Less: Current portion of long-term debt	(12,000)	(14,171)
Long-term debt, net	97,009	$ 98,130
Term Loan
Long-term Debt, by Current and Noncurrent [Abstract]
Remainder of 2019	2,500
2020	5,000
2021	6,250
2022	7,500
2023	8,750
2024	70,000
Long-term Debt	100,000
Less:  Current portion of long-term debt	(6,250)
Less:  Debt issuance costs	(723)
Long-term debt, net	93,027
Financing Obligations
Finance Obligations
Remainder of 2019	1,667
2020	5,270
2021	2,455
2022	340
2023	0
2024	0
Finance obligations, due	9,732
Less: Current portion of long-term debt	(5,750)
Long-term portion of finance lease obligations	$ 3,982

Derivative Instruments and He_3

Derivative Instruments and Hedging Activities (Details) - USD ($)	9 Months Ended
	Sep. 30, 2019	Dec. 31, 2018	Sep. 30, 2018
Cash Flow Hedging | Designated as Hedging Instrument | Interest Rate Hedge December 2016
Derivative [Line Items]
Total notional amount	$ 50,000,000	$ 50,000,000
Fixed interest rate	1.59%	1.59%
Cash Flow Hedging | Designated as Hedging Instrument | Interest Rate Hedge June 2018
Derivative [Line Items]
Total notional amount	$ 20,000,000	$ 20,000,000
Fixed interest rate	2.98%	2.98%
Cash Flow Hedging | Designated as Hedging Instrument | Interest Rate Swap
Derivative [Line Items]
Notional amount increase upon maturity	$ 70,000,000
Other Noncurrent Assets | Interest Rate Swap
Derivative [Line Items]
Fair value of derivative instrument	$ 40,000	$ 480,000
Other Noncurrent Liabilities | Interest Rate Swap
Derivative [Line Items]
Fair value of derivative instrument		$ 900,000	$ 2,300,000

Class A Redeemable Convertibl_2

Class A Redeemable Convertible Preferred Stock (Detail) - USD ($) $ / shares in Units, $ in Thousands	Jun. 25, 2018	Jun. 24, 2018	Dec. 22, 2016	Sep. 30, 2019	Sep. 30, 2018	Jun. 30, 2018	Sep. 30, 2019	Sep. 30, 2018	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2018	Mar. 31, 2018	Dec. 31, 2017	Dec. 30, 2015
Temporary Equity [Line Items]
Redemption of preferred stock							$ 0	$ 50,096
Gain on redemption of preferred stock				$ 0	$ 0	$ 9,075	$ 0	$ 9,075
Series A Redeemable Convertible Preferred Stock
Temporary Equity [Line Items]
Temporary equity, shares issued														14,666,667
Temporary equity, face value (in dollars per share)			$ 7.50											$ 7.50
Temporary equity, liquidation value			$ 49,500											$ 110,000
Temporary equity shares redemption (in shares)			8,066,667
Temporary equity redemption amount			$ 55,000
Temporary equity, redemption per share (in dollars per share)	$ 7.30		$ 6.82
Redemption discounts percentage	4.55%		9.09%
Temporary equity, shares outstanding				0	0	0	0	0	0	0	0	6,864,000	6,864,000
Redemption of preferred stock	$ 50,100
Additional amount per share added for accrued and unpaid dividends (in dollars per share)	$ 0.14
Gain on redemption of preferred stock		$ 9,100				$ 0
Temporary equity, carrying amount		37,800
Temporary equity, recognized amount of beneficial conversion feature		$ (21,300)
Temporary equity, fair value			$ 32,900											$ 73,200
Temporary equity issued, price per share (in dollars per share)			$ 4.99											$ 4.99
Temporary equity issue discount			$ 16,600											$ 36,800
Temporary equity, value of beneficial conversion feature			$ 20,100											$ 44,700
Temporary equity, beneficial conversion feature, recognition period (in years)							3 years
Series A Redeemable Convertible Preferred Stock | Payment In Kind Period Two
Temporary Equity [Line Items]
Temporary equity, shares issued													264,000

Equity - Narrative (Detail)

Equity - Narrative (Detail) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended		3 Months Ended						9 Months Ended
	Jun. 30, 2019	May 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Sep. 30, 2018
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense (gain)			$ 3,300			$ 1,100			$ 7,700	$ 5,000
Unrecognized stock-based compensation cost			5,700						$ 5,700
Unrecognized share-based compensation expense, weighted-average recognition period (in years)									1 year 4 months 13 days
Common stock issuance ESPP Plan			$ 564	$ 653	$ 419	$ 267	$ 231	$ 267
Working capital adjustment, return of shares (in shares)	99,254
Issuance of common stock, net									$ 10,132	$ 6,535
Employee Stock Purchase Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Employee stock purchase plan, discount rate (as a percent)									15.00%
Common stock issuance ESPP Plan (in shares)			28,672			21,100			101,959	87,288
Common stock issuance ESPP Plan			$ 100			$ 100			$ 400	$ 200
Public Stock Offering
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares issued in offering		8,050,000
Sale of stock (in dollars per share)		$ 21.25
Issuance of common stock, net		$ 171,100
Consideration received from offering		160,800
Payments of stock issuance costs		$ 10,300

Equity - Summary of Stock Optio

Equity - Summary of Stock Option Activity (Detail) - $ / shares	9 Months Ended
	Sep. 30, 2019
Number of shares
Beginning balance (in shares)	6,839,417
Options granted (in shares)	943,345
Less:
Options exercised (in shares)	1,439,869
Options canceled or expired (in shares)	174,927
Ending balance (in shares)	6,167,966
Exercisable at September 30, 2019 (in shares)	2,995,419
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in dollars per share)	$ 7.63
Weighted average exercise price, granted (in dollars per share)	19.74
Less:
Weighted average exercise price, exercised (in dollars per share)	6.58
Weighted average exercise price, canceled or expired (in dollars per share)	13.15
Weighted average exercise price, ending balance (in dollars per share)	9.56
Weighted average exercise price, exercisable, ending balance (in dollars per share)	$ 7.20

Equity - Fair Value of Each Sto

Equity - Fair Value of Each Stock Option Award Granted (Detail)	9 Months Ended
	Sep. 30, 2019$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate (%)	2.50%
Dividend yield (%)	0.00%
Weighted average fair value/share at grant date (in dollars per share)	$ 5.76
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	3 years
Expected volatility (%)	38.90%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	4 years 6 months
Expected volatility (%)	44.00%

Equity - Summary of Restricted

Equity - Summary of Restricted Stock Activity (Details) - Restricted Stock	9 Months Ended
	Sep. 30, 2019$ / sharesshares
Number of shares
Beginning balance (in shares) | shares	282,508
Granted (in shares) | shares	227,188
Vested (in shares) | shares	(121,801)
Forfeited (in shares) | shares	(51,389)
Ending balance (in shares) | shares	336,506
Weighted average price
Beginning balance (in dollars per share) | $ / shares	$ 9.01
Granted (in dollars per share) | $ / shares	19.91
Vested (in dollars per share) | $ / shares	9.60
Forfeited (in dollars per share) | $ / shares	11.72
Ending balance (in dollars per share) | $ / shares	$ 15.75

Income Taxes (Details)

Income Taxes (Details)	9 Months Ended
	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Effective tax rate (as a percent)	(41.30%)

Commitments and Contingencies (

Commitments and Contingencies (Detail) - Health Discovery Corporation Case - USD ($) $ in Millions	Apr. 25, 2019	Jun. 30, 2019	Mar. 31, 2019
Milestone and Royalty Payment
Contractual Obligation [Line Items]
Amount awarded to HDC	$ 1.5
Lack of Development and Commercialization
Contractual Obligation [Line Items]
Amount awarded to HDC	$ 5.1	$ 6.7
Loss contingency accrual			$ 4.9

Related Party Transactions (Det

Related Party Transactions (Detail) - USD ($)	Jun. 06, 2019	May 06, 2019	Jun. 01, 2018	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Related Party Transaction [Line Items]
Options granted (in shares)						943,345
Options granted, price (in dollars per share)						$ 19.74
Executive Vice President
Related Party Transaction [Line Items]
Related party retainer compensation		$ 5,000
Fees for performing duties				$ 15,750	$ 38,000	$ 76,250	$ 125,000
Related party transaction compensation for services on board				$ 13,125	$ 12,500	$ 38,125	$ 37,500
Options granted (in shares)	4,269		3,017
Options granted, price (in dollars per share)	$ 22.52		$ 11.60
Fair market value of options granted (in dollars per share)	$ 8.14		$ 3.74
Restricted Stock
Related Party Transaction [Line Items]
Restricted stock granted (in shares)						227,188
Restricted stock granted, fair value (in dollars per share)						$ 19.91
Restricted Stock | Executive Vice President
Related Party Transaction [Line Items]
Restricted stock granted (in shares)	3,419		6,897
Restricted stock granted, fair value (in dollars per share)	$ 22.52		$ 11.60

Segment Information (Details)

Segment Information (Details) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2019USD ($)	Jun. 30, 2019USD ($)	Mar. 31, 2019USD ($)	Sep. 30, 2018USD ($)	Jun. 30, 2018USD ($)	Mar. 31, 2018USD ($)	Sep. 30, 2019USD ($)segment	Sep. 30, 2018USD ($)
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

Uncategorized Items - neo-20190

Label	Element	Value
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ 35,000
Retained Earnings [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	1,130,000
Additional Paid-in Capital [Member]
Cumulative Effect of New Accounting Principle in Period of Adoption	us-gaap_CumulativeEffectOfNewAccountingPrincipleInPeriodOfAdoption	$ (1,095,000)