NeoGenomics (NEO) 10-Q 31 Jul 20 2020 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2020	Jul. 28, 2020
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2020
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, City or Town	Fort Myers,
Entity Address, State or Province	FL
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		110,430,630
Entity Central Index Key	0001077183
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2020
Document Fiscal Period Focus (i.e. Q1,Q2,Q3,FY)	Q2
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Current assets
Cash and cash equivalents	$ 295,281	$ 173,016
Accounts receivable, net	87,766	94,242
Inventories	21,627	14,405
Prepaid assets	8,300	6,327
Other current assets	6,026	2,748
Total current assets	419,000	290,738
Property and equipment (net of accumulated depreciation of $80,143 and $68,809, respectively)	83,969	64,188
Operating lease right-of-use assets	47,554	26,492
Intangible assets, net	125,821	126,640
Goodwill	210,833	198,601
Restricted cash, non-current	36,030	0
Prepaid lease asset	6,084	0
Investment in non-consolidated affiliate	13,137	0
Other assets	3,057	2,847
Total assets	945,485	709,506
Current liabilities
Accounts payable	19,198	19,568
Accrued compensation	22,065	21,365
Accrued expenses and other liabilities	7,913	7,548
Short-term portion of financing obligations	4,458	5,432
Short-term portion of operating leases	4,496	3,381
Current secured debt	0	5,000
Pharma contract liability	3,570	1,610
Total current liabilities	61,700	63,904
Long-term liabilities
Convertible senior notes, net	164,544	0
Long-term debt, net	1,911	3,199
Long-term portion of operating leases	44,524	24,034
Long-term portion of term loan, net	0	91,829
Other long-term liabilities	3,155	3,566
Deferred income tax liability, net	15,422	15,566
Total long-term liabilities	229,556	138,194
Total liabilities	291,256	202,098
Stockholders' equity
Common stock, $0.001 par value, (250,000,000 shares authorized; 110,396,844 and 104,781,236 shares issued and outstanding, respectively)	110	105
Additional paid-in capital	679,235	520,278
Accumulated other comprehensive loss	43	(1,618)
Accumulated deficit	(25,159)	(11,357)
Total stockholders’ equity	654,229	507,408
Total liabilities and stockholders' equity	$ 945,485	$ 709,506

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Property and equipment, accumulated depreciation	$ 80,143	$ 68,809
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	110,396,844	104,781,236
Common stock, shares outstanding	110,396,844	104,781,236

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Total revenue	$ 86,977	$ 101,713	$ 193,007	$ 197,290
COST OF REVENUE	58,971	52,747	118,632	101,209
Total gross profit	28,006	48,966	74,375	96,081
Operating expenses:
General and administrative	34,613	29,577	70,957	61,719
Research and development	2,105	2,587	4,165	3,796
Sales and marketing	10,195	12,324	23,453	23,540
Total operating expenses	46,913	44,488	98,575	89,055
(Loss) income from operations	(18,907)	4,478	(24,200)	7,026
Interest expense, net	1,548	1,304	2,367	3,130
Other (income) expense, net	(7,405)	(10)	(7,628)	5,159
Loss on extinguishment of debt	1,400	1,018	1,400	1,018
Loss on termination of cash flow hedge	3,506	0	3,506	0
(Loss) income before taxes	(17,956)	2,166	(23,845)	(2,281)
Income tax (benefit) expense	(11,132)	175	(10,043)	(1,848)
Net (loss) income	$ (6,824)	$ 1,991	$ (13,802)	$ (433)
NET (LOSS) INCOME PER SHARE
Basic (in dollars per share)	$ (0.06)	$ 0.02	$ (0.13)	$ 0
Diluted (in dollars per share)	$ (0.06)	$ 0.02	$ (0.13)	$ 0
WEIGHTED AVERAGE COMMON SHARES OUTSTANDING
Basic (in shares)	107,887	98,297	106,209	96,734
Diluted (in shares)	107,887	102,336	106,209	96,734
Clinical Services
Total revenue	$ 73,884	$ 88,982	$ 166,866	$ 175,192
Total gross profit	25,127	42,602	69,186	86,161
Pharma Services
Total revenue	13,093	12,731	26,141	22,098
Total gross profit	$ 2,879	$ 6,364	$ 5,189	$ 9,920

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE (LOSS) INCOME - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Statement of Comprehensive Income [Abstract]
NET (LOSS) INCOME	$ (6,824)	$ 1,991	$ (13,802)	$ (433)
OTHER COMPREHENSIVE (LOSS) INCOME:
Gain (loss) on effective cash flow hedges	38	(1,027)	(1,000)	(1,584)
Cash flow hedge termination reclassified to earnings	2,661	0	2,661	0
Total other comprehensive income (loss), net of tax	2,699	(1,027)	1,661	(1,584)
COMPREHENSIVE (LOSS) INCOME	$ (4,125)	$ 964	$ (12,141)	$ (2,017)

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	3 Months Ended				6 Months Ended		12 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
CASH FLOWS FROM OPERATING ACTIVITIES
Net loss	$ (6,824)	$ (6,978)	$ 1,991	$ (2,424)	$ (13,802)	$ (433)
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation					12,177	10,352
Loss on disposal of assets					263	404
Loss on extinguishment of debt	1,400		1,018		1,400	1,018	$ 1,400
Loss on termination of cash flow hedge	3,506		0		3,506	0
Amortization of intangibles	2,500		2,500		4,919	5,102
Amortization of debt issue costs					112	250
Amortization of convertible debt discount					864	0
Non-cash stock-based compensation					4,821	4,452
Non-cash operating lease expense					4,113	2,218
Changes in assets and liabilities, net
Accounts receivable, net					6,498	(13,178)
Inventories					(6,688)	(83)
Prepaid and other assets					(5,282)	(383)
Prepaid lease asset					(6,084)	0
Other current assets					(693)	(1,897)
Accounts payable, accrued and other liabilities					(11,175)	(6,446)
Net cash (used in) provided by operating activities					(5,051)	1,376
CASH FLOWS FROM INVESTING ACTIVITIES
Purchases of property and equipment					(9,734)	(6,637)
Business acquisition					(37,000)	0
Acquisition working capital adjustment					0	399
Investment in non-consolidated affiliate					(13,137)	0
Net cash used in investing activities					(59,871)	(6,238)
CASH FLOWS FROM FINANCING ACTIVITIES
Repayment of revolving credit facility					0	(5,000)
Repayment of equipment financing obligations					(3,059)	(3,644)
Proceeds from term loan					0	100,000
Repayment of term loan					(97,540)	(96,750)
Cash flow hedge termination					(3,317)	0
Payments of debt issuance costs					0	(954)
Issuance of common stock, net					5,469	8,061
Proceeds from issuance of convertible debt, net of issuance costs					194,376	0
Proceeds from equity offering, net of issuance costs					127,288	160,774
Net cash provided by financing activities					223,217	162,487
Net change in cash, cash equivalents and restricted cash					158,295	157,625
Cash, cash equivalents and restricted cash, beginning of period		$ 173,016		$ 9,811	173,016	9,811	9,811
Cash, cash equivalents and restricted cash, end of period	331,311		167,436		331,311	167,436	173,016
Cash and cash equivalents	295,281		167,436		295,281	167,436	173,016
Restricted cash, non-current	$ 36,030		$ 0		36,030	0	$ 0
Supplemental disclosure of cash flow information:
Interest paid					1,562	3,178
Income taxes paid, net					89	235
Supplemental disclosure of non-cash investing and financing information:
Working capital adjustment related to acquisition					0	1,977
Equipment acquired under financing obligations					428	2,702
Property and equipment included in accounts payable					$ 2,487	$ 970

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income (Loss)	Accumulated Deficit
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)
Gain (loss) 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 (LOSS) 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)
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]
Cash flow hedge termination reclassified to earnings	0
NET (LOSS) INCOME	(433)
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)
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)
Gain (loss) on effective cash flow hedges	(1,027)			(1,027)
Cash flow hedge termination reclassified to earnings	0
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 (LOSS) 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)
Beginning balance (in shares) at Dec. 31, 2019		104,781,236
Beginning balance at Dec. 31, 2019	507,408	$ 105	520,278	(1,618)	(11,357)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)		34,330
Common stock issuance ESPP Plan	796		796
Stock issuance fees and expenses	(15)		(15)
Gain (loss) on effective cash flow hedges	(1,038)			(1,038)
Issuance of restricted stock, net of forfeitures (in shares)		(76,618)
Issuance of restricted stock, net of forfeitures	(212)		(212)
Issuance of common stock for stock options (in shares)		503,873
Issuance of common stock for stock options	2,897		2,897
ESPP expense	194		194
Stock-based compensation expense - options and restricted stock	1,991		1,991
NET (LOSS) INCOME	(6,978)				(6,978)
Ending balance (in shares) at Mar. 31, 2020		105,396,057
Ending balance at Mar. 31, 2020	505,043	$ 105	525,929	(2,656)	(18,335)
Beginning balance (in shares) at Dec. 31, 2019		104,781,236
Beginning balance at Dec. 31, 2019	507,408	$ 105	520,278	(1,618)	(11,357)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cash flow hedge termination reclassified to earnings	$ 2,661
Issuance of common stock for stock options (in shares)	691,299
NET (LOSS) INCOME	$ (13,802)
Ending balance (in shares) at Jun. 30, 2020		110,396,844
Ending balance at Jun. 30, 2020	654,229	$ 110	679,235	43	(25,159)
Beginning balance (in shares) at Mar. 31, 2020		105,396,057
Beginning balance at Mar. 31, 2020	505,043	$ 105	525,929	(2,656)	(18,335)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issuance ESPP Plan (in shares)		41,058
Common stock issuance ESPP Plan	928		928
Stock issuance fees and expenses	(317)		(317)
Gain (loss) on effective cash flow hedges	38			38
Cash flow hedge termination reclassified to earnings	2,661			2,661
Issuance of restricted stock, net of forfeitures (in shares)		(24,786)
Issuance of restricted stock, net of forfeitures	(824)		(824)
Issuance of common stock - Public Offering (in shares)		4,751,500
Issuance of common stock - Public Offering	127,293	$ 5	127,288
Issuance of common stock for stock options (in shares)		183,443
Issuance of common stock for stock options	2,014		2,014
ESPP expense	211		211
Stock-based compensation expense - options and restricted stock	2,424		2,424
Equity component of convertible note issuance	30,912		30,912
Tax liability related to convertible note issuance	(9,330)		(9,330)
NET (LOSS) INCOME	(6,824)				(6,824)
Ending balance (in shares) at Jun. 30, 2020		110,396,844
Ending balance at Jun. 30, 2020	$ 654,229	$ 110	$ 679,235	$ 43	$ (25,159)

Nature of the Business, Basis o

Nature of the Business, Basis of Presentation and Significant Accounting Policies	6 Months Ended
	Jun. 30, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of the Business, Basis of Presentation and Significant Accounting Policies	Nature of the Business, Basis of Presentation and Significant Accounting Policies Nature of the Business 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. Basis of Presentation 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. All intercompany transactions and balances have been eliminated in the accompanying consolidated financial statements. Unaudited Interim Financial Information 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, 2019. 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. Principles of Consolidation 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 represents 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 14. Segment Information, in the accompanying notes to the consolidated financial statements. The Company determines whether investments in affiliates are a Variable Interest Entity (“VIE”) at the start of each new venture and when a reconsideration event has occurred. A reporting entity must consolidate a VIE if that reporting entity has a variable interest (or combination of variable interests) and is determined to be the primary beneficiary. The primary beneficiary has both the power to direct the activities of the VIE that most significantly impact the entity’s economic performance and the obligation to absorb losses or the right to receive benefits from the VIE that could potentially be significant to the VIE. The Company accounts for its investments that are under 20% of the total equity outstanding and for which the Company does not have significant influence by applying the cost method. Investments that are under 20% of the total equity outstanding and for which the entity does have significant influence are accounted for using the equity method unless a scope exception is applicable. Investments in which the Company holds a non-controlling interest and are between 20-50% equity are accounted for using the equity method. For any investments in which the Company holds over 50% of the outstanding stock, or for investments in which the Company controls the investee, the Company consolidates those entities into their consolidated financial statements. COVID-19 Pandemic In December 2019, a novel strain of coronavirus (“COVID-19”) was identified and the disease has since spread across the world, including the United States. In March 2020, the World Health Organization declared the outbreak of COVID-19 a pandemic. The outbreak of the pandemic is materially adversely affecting the Company’s employees, patients, communities and business operations, as well as the U.S. economy and financial markets. The full extent to which the COVID-19 outbreak will impact the Company’s business, results of operations, financial condition and cash flows will depend on future developments that are highly uncertain and cannot be accurately predicted, including new information that may emerge concerning COVID-19 and the actions to contain it or treat its impact and the economic impact on local, regional, national and international markets. As the COVID-19 pandemic continues, the Company’s results of operations, financial condition and cash flows are likely to continue to be materially adversely affected, particularly if the pandemic persists for a significant amount of time. Coronavirus Aid, Relief, and Economic Security Act The Federal government passed legislation and the President of the United States signed into law on March 27, 2020, known as the Coronavirus Aid, Relief, and Economic Security Act (the “CARES Act”). On April 10, 2020, the U.S Department of Health & Human Services (“HHS”) announced that Medicare-enrolled providers would receive a portion of a direct deposit disbursement totaling $50 billion. The $50 billion is part of a $100 billion Public Health and Emergency Fund created by the CARES Act and payments made are intended to reimburse healthcare providers for health care related expenses or lost revenues attributable to COVID-19 and are not required to be repaid provided that recipients attest to and comply with certain terms and conditions, including limitations on balance billing for COVID-19 patients. In the absence of specific guidance to account for government grants under GAAP, the Company accounts for such grants in accordance with international accounting standards for government grants. Such amounts are recognized when there is reasonable assurance that the Company will (1) comply with the conditions associated with the grant and (2) receive the grant. For the three and six month periods ended June 30, 2020, the Company recognized $7.9 million in grant income related to the CARES Act. CARES Act grant income is classified in “Other (income) expense, net”, on the Consolidated Statements of Operations. There was no grant income recognized for the three-month and six-month periods ended June 30, 2019. Additionally, the CARES Act permits the deferral of payment of the employer portion of social security taxes between March 27, 2020 and December 31, 2020, with 50% of the deferred amount due December 31, 2021 and the remaining 50% due December 31, 2022. As of June 30, 2020, the accrued deferred social security taxes related to the CARES Act were $2.1 million. This amount was recorded in “Other long-term liabilities” on the Consolidated Balance Sheets. There were no such amounts recorded on the Consolidated Balance Sheets as of December 31, 2019.

Recently Adopted and Issued Acc

Recently Adopted and Issued Accounting Guidance	6 Months Ended
	Jun. 30, 2020
Accounting Changes and Error Corrections [Abstract]
Recently Adopted and Issued Accounting Guidance	Recently Adopted and Issued Accounting Guidance Recently Adopted Accounting Guidance In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows ( “ Topic 230 ” ): Restricted Cash . The new guidance requires that the reconciliation of the beginning-of-period and end-of-period amounts shown in the statement of cash flows include cash, cash equivalents and restricted cash. ASU 2016-08 was effective for fiscal years beginning after December 15, 2017, including interim periods within those periods, using a retrospective transition method to each period presented. As a result, restricted cash of approximately $36 million as of June 30, 2020 is included in cash and cash equivalents when reconciling the beginning and ending balances in the Consolidated Statements of Cash Flows. Please refer to Note 3. Leases, for additional information regarding the use of restricted cash. There were no restricted cash balances in any reportable period prior to January 2020. In June 2016, the FASB issued ASU No. 2016-13, Financial Instruments – Credit Losses (“Topic 326”) : Measurement of Credit Losses on Financial Instruments, as modified by subsequently issued ASUs 2018-19 (issued November 2018), 2019-04 (issued April 2019), 2019-05 (issued May 2019), 2019-11 (issued November 2019), 2020-02 (issued February 2020) and 2020-03 (issued March 2020). Topic 326 modifies the measurement and recognition of credit losses for most financial assets and certain other instruments. The standard was effective January 1, 2020 and requires the use of forward-looking expected credit loss models based on historical experience, current economic 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. It 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 required a modified retrospective approach with a cumulative effect adjustment to retained earnings. The Company adopted and applied the standard as of January 1, 2020. Based on management’s analysis, Topic 326 is applicable to the Company’s trade receivables as well as contract assets recognized within the Pharma Services segment. An assessment was performed on historical trends, current economic conditions, supportable forecasts, and customer and credit risks. The adoption of Topic 326 did not result in a material impact on the Company's Consolidated Financial Statements. Accounting Pronouncements Pending Adoption In March 2020, the FASB issued ASU No. 2020-04, Reference Rate Reform ( “ Topic 848 ” ): Facilitation of the Effects of Reference Rate Reform on Financial Reporting. ASU 2020-04 provides for temporary optional expedients and exceptions to the current guidance on certain contract modifications and hedging relationships to ease the burdens related to the expected market transition from the London Inter-bank Offered Rate ( “ LIBOR ” ) or other reference rates to alternative reference rates. The guidance is effective upon issuance and can be applied through December 31, 2022. The Company does not expect the adoption of this standard to have a material impact on its Consolidated Financial Statements. In January 2020, the FASB issued ASU No. 2020-01, Investments-Equity Securities (“Topic 321”), Investments-Equity Method and Joint Ventures (“Topic 323”) and Derivatives and Hedging (“Topic 815”) (ASU 2020-01). ASU 2020-01 clarifies the interaction of the accounting for equity securities under Topic 321, the accounting for the equity method investments in Topic 323 and the accounting for certain forward contracts and purchased options in Topic 815. ASU 2020-01 is effective for fiscal years beginning after December 15, 2020 on a prospective basis and early adoption is permitted. The Company does not expect the adoption of this standard to have a material impact on its Consolidated Financial Statements. In December 2019, the FASB issued ASU No. 2019-12, Income Taxes: Simplifying the Accounting for Income Taxes (“Topic 740”) , which simplifies the accounting for income taxes, eliminates certain exceptions within Topic 740 and clarifies certain other aspects of the current guidance to promote consistency among reporting entities. The new standard is effective for fiscal years beginning after December 15, 2020 on a prospective basis and early adoption is permitted. The Company is currently evaluating the impact of the provisions of this standard on the Company’s Consolidated Financial Statements.

Leases

Leases	6 Months Ended
	Jun. 30, 2020
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 15 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. 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 June 30, 2020, 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 2020 $ 2,984 2021 7,706 2022 5,431 2023 5,289 2024 5,349 Thereafter 37,569 Total remaining lease payments 64,328 Less: imputed interest (15,308) Total operating lease liabilities 49,020 Less: current portion (4,496) Long-term operating lease liabilities $ 44,524 Weighted-average remaining lease term (in years) 12.0 Weighted-average discount rate 4.4 % The following summarizes additional supplemental data related to our operating leases (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Operating lease costs $ 2,172 $ 1,547 $ 4,277 $ 3,094 Six Months Ended June 30, 2020 2019 Right-of-use assets obtained in exchange for operating lease liabilities $ 24,071 $ 18,563 Cash paid for operating leases $ 3,354 $ 1,863

Revenue Recognition and Contrac

Revenue Recognition and Contractual Adjustments	6 Months Ended
	Jun. 30, 2020
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, oncology 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, including 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 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 Sheets. 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 as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, 2019 Current pharma contract assets (1) $ 1,255 $ 1,000 Long-term pharma contract assets (2) 221 153 Total pharma contract assets $ 1,476 $ 1,153 Current pharma capitalized commissions (1) $ 183 $ 133 Long-term pharma capitalized commissions (2) 820 798 Total pharma capitalized commissions $ 1,003 $ 931 Current pharma contract liabilities $ 3,570 $ 1,610 Long-term pharma contract liabilities (3) 631 1,171 Total pharma contract liabilities $ 4,201 $ 2,781 (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 $0.3 million, or 28%, from December 31, 2019 to June 30, 2020. Pharma contract liabilities increased $1.4 million, or 51%, during the same period, while capitalized commissions increased slightly. Revenue recognized for the three and six months ended June 30, 2020 related to Pharma contract liability balances outstanding at the beginning of the period was $0.4 million and $1.6 million, respectively. Amortization of capitalized commissions for both three and six months ended June 30, 2020 was $0.1 million and $0.3 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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Clinical Services: Client direct billing $ 45,244 $ 54,008 $ 99,535 $ 103,243 Commercial Insurance 15,148 20,894 37,142 41,802 Medicare and Medicaid 13,541 13,719 30,024 29,581 Self-Pay (49) 361 165 566 Total Clinical Services $ 73,884 $ 88,982 $ 166,866 $ 175,192 Pharma Services: 13,093 12,731 26,141 22,098 Total Revenue $ 86,977 $ 101,713 $ 193,007 $ 197,290

Acquisition

Acquisition	6 Months Ended
	Jun. 30, 2020
Business Combinations [Abstract]
Acquisition	Acquisition On January 10, 2020 (the “Acquisition Date”), the Company acquired the Oncology Division assets of Human Longevity, Inc. (“HLI - Oncology”) for a purchase price consisting of cash consideration of $37 million. Acquisition and integration costs related to HLI - Oncology were approximately $0.1 million and $1.4 million for the three and six months ended June 30, 2020, respectively, and are reported as general and administrative expenses in the Company's Consolidated Statements of Operations. HLI - Oncology performs Next-Generation Sequencing for pharmaceutical customers. The acquisition of HLI - Oncology adds whole exome and whole genome sequencing capabilities to the Company's current Pharma Services offerings. Revenue related to HLI - Oncology is reported in the Pharma Services segment. The acquisition included assets, primarily consisting of lab equipment, inventory, maintenance agreements for acquired equipment, backlog contracts with HLI - Oncology's customers, as well as HLI - Oncology’s molecular workforce that is experienced with Next-Generation Sequencing. The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Acquisition Date (in thousands): January 10, 2020 Inventory $ 534 Prepaid assets 185 Property and equipment 16,839 Internally developed software 3,110 Customer relationships (1) 4,100 Long-term assets 346 Goodwill (2) 12,232 Total assets acquired $ 37,346 Long-term liabilities (346) Net assets acquired $ 37,000 (1) Acquired intangible assets consisted of customer relationships which are amortized over seven years. (2) The goodwill arising from the acquisition of HLI - Oncology is the amount the Company paid in excess of the fair value of the net assets acquired and was primarily for (i) the expected future cash flows derived from the existing business capabilities and infrastructure, (ii) expanding the Company's scientific expertise as a leading provider of Pharma Services and Next-Generation Sequencing and (iii) an enhanced Pharma Services menu including germline, whole exome and whole genome sequencing. All of the goodwill resulting from the acquisition of HLI - Oncology is expected to be deductible for income tax purposes. The above purchase price and purchase price allocation are preliminary and subject to future revision as the acquired assets and liabilities assumed are dependent upon the finalization of the related valuations. The fair values assigned to assets acquired and liabilities assumed for HLI - Oncology are based upon management's best estimates and assumptions as of the reporting date, and are considered preliminary.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill as of June 30, 2020 and December 31, 2019 was $210.8 million and $198.6 million, respectively. Intangible assets consisted of the following as of (in thousands): June 30, 2020 Amortization Cost Accumulated Net Customer Relationships 84-180 months 143,371 30,997 112,374 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,818 $ 30,997 $ 125,821 December 31, 2019 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,679 $ 3,679 $ — Non-Compete Agreement 24 months 27 27 — Customer Relationships 180 months 139,271 26,078 113,193 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,424 $ 29,784 $ 126,640 The Company recorded approximately $2.5 million in straight-line amortization expense of intangible assets for both the three months ended June 30, 2020 and 2019 and approximately $4.9 million and $5.1 million for the six months ended June 30, 2020 and 2019, 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 June 30, 2020 is as follows (in thousands): Remainder of 2020 $ 4,935 2021 9,870 2022 9,870 2023 9,870 2024 9,870 Thereafter 67,959 Total $ 112,374

Debt

Debt	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Debt	DebtThe following table summarizes the long-term debt, net at June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, 2019 1.25% Senior Convertible Notes due 2025 Principal $ 201,250 $ — Unamortized debt discount (36,086) — Unamortized debt issuance costs (621) — Total 1.25% Senior Convertible Notes due 2025 164,543 — Term loan Principal $ — $ 97,500 Unamortized debt issuance costs — (671) Total term loan — 96,829 Financing obligations 6,369 8,631 Total debt $ 170,912 $ 105,460 Less: Current portion of long-term debt — (5,000) Less: Current portion of financing obligations (4,458) (5,432) Total long-term debt, net $ 166,454 $ 95,028 The carrying value of the Company’s term loan and financing obligations approximates fair value based on the current market conditions for similar instruments. 1.25% Convertible Senior Notes On May 4, 2020 (the “Closing Date”), the Company completed the sale of $201.3 million of Convertible Senior Notes with a stated interest rate of 1.25% and a maturity date of May 1, 2025 (the “Convertible Notes”), unless earlier converted, redeemed, or repurchased. The Convertible Notes were issued at a discounted price of 97% of their principal amount. The total net proceeds from the issuance of the Convertible Notes and exercise of the Over-allotment Option was approximately $194.4 million, which includes approximately $6.9 million of discounts, commissions and offering expenses paid by the Company. On May 4, 2020, the Company entered into an Indenture (the “Indenture”), with U.S. Bank National Association, as trustee (the “Trustee”), governing the Convertible Notes. Prior to February 1, 2025, noteholders may convert their Convertible Notes at their option, only in the following circumstances: (1) during any calendar quarter commencing after the calendar quarter ending on September 30, 2020 (and only during such calendar quarter), if the last reported sale price of the common stock for at least 20 trading days (whether or not consecutive) during a period of 30 consecutive trading days ending on, and including, the last trading day of the immediately preceding calendar quarter is greater than or equal to 130% of the conversion price on each applicable trading day; (2) during the five business day period after any five consecutive trading day period in which the trading price per $1,000 principal amount of Convertible Notes for each trading day of the measurement period was less than 98% of the product of the last reported sale price of the Company’s common stock and the conversion rate on each such trading day; (3) if the Company calls any or all of the notes for redemption, at any time prior to the close of business on the scheduled trading day immediately preceding the redemption date; or (4) upon the occurrence of specified corporate events. On or after February 1, 2025 until the close of business on the business day immediately preceding the maturity date, noteholders may convert their Convertible Notes at any time, regardless of the foregoing circumstances. Upon conversion, the Company will pay or deliver, as applicable, cash, shares of common stock or a combination of cash and shares of common stock, at its election. The initial conversion rate for the Convertible Notes is 27.5198 shares of common stock per $1,000 in principal amounts of Convertible Note, equivalent to an initial conversion price of approximately $36.34 per share of common stock. The conversion rate is subject to adjustment as described in the Indenture. In addition, following certain corporate events that occur prior to the maturity date as described in the Indenture, the Company will pay a make-whole premium by increasing the conversion rate for a holder who elects to convert its Convertible Notes in connection with such a corporate event in certain circumstances. For purposes of calculating earnings per share, if the average market price of the Company's common stock exceeds the applicable conversion price during the periods reported, shares contingently issuable under the Convertible Notes will have a dilutive effect to the common stock. Since the conversion price of $36.34 exceeded the Company's closing common stock price of $30.98 at the end of the period, the if-converted value did not exceed the principal amount of the Convertible Notes at June 30, 2020. The Company may not redeem the Convertible Notes prior to May 6, 2023. The Company may redeem for cash all or any portion of the Convertible Notes, at its option, on or after May 6, 2023 if the last reported sale price of its common stock has been at least 130% of the conversion price then in effect for at least 20 trading days (whether or not consecutive) during any 30 consecutive trading day period (including the last trading day of such period) ending on, and including, the trading day immediately preceding the date of notice by the Company of redemption at a redemption price equal to 100% of the principal amount of the Convertible Notes to be redeemed, plus accrued and unpaid interest to, but excluding, the redemption date. No sinking fund is provided for the Convertible Notes. If an event involving bankruptcy, insolvency or reorganization events with respect to the Company occurs, then the principal amount of, and all accrued and unpaid interest on, all of the Convertible Notes then outstanding will immediately become due and payable. If any other default event occurs and is continuing, then noteholders of at least 25% of the aggregate principal amount of the Convertible Notes then outstanding, by notice to the Company, may declare the principal amount of, and all accrued and unpaid interest on, all of the Convertible Notes then outstanding to become due and payable immediately. If the Company undergoes a “fundamental change” as defined in the Indenture, then noteholders may require the Company to repurchase their Convertible Notes at a cash repurchase price equal to the principal amount of the Convertible Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date. The Convertible Notes are the Company’s senior, unsecured obligations and will be equal in right of payment with its existing and future senior, unsecured indebtedness, senior in right of payment to its existing and future indebtedness that is expressly subordinated to the Convertible Notes and effectively junior to its existing and future secured indebtedness, to the extent of the value of the collateral securing that indebtedness. The Convertible Notes will be structurally subordinated to all existing and future indebtedness and other liabilities, including trade payables, of its subsidiaries. The interest expense recognized on the Convertible Notes includes $0.4 million, $0.9 million and $19,100 for the contractual coupon interest, the accretion of the debt discount and the amortization of the debt issuance costs, respectively, for both the three and six months ended June 30, 2020. The effective interest rate on the Convertible Notes is 5.5%, which includes the interest on the Convertible Notes and amortization of the debt discount and debt issuance costs. Interest on the Convertible Notes began accruing upon issuance and is payable semi-annually. The Convertible Notes are accounted for as separate liability and equity components. The carrying amount of the liability component was calculated by measuring the fair value of a similar liability that does not have an associated convertible feature. The allocation was performed in a manner that reflected the Company’s non-convertible debt borrowing rate for similar debt. The equity component of the Convertible Notes was recognized as a debt discount and represents the difference between the proceeds from the issuance of the Convertible Notes and the fair value of the liability of the Convertible Notes on the date of issuance. At the Closing Date, the equity component representing the conversion option was determined to be $21.6 million, net of tax, and was initially recorded by deducting the carrying value of the liability component from the initial proceeds from the Convertible Notes. The excess of the principal amount of the Convertible Notes over the carrying amount of the liability component represents a debt discount that is amortized to interest expense over the term of the Convertible Notes under the effective interest rate method. The equity component is not re-measured as long as it continues to meet the conditions for equity classification. Prior Senior Secured Credit Agreement On May 4, 2020, the Company terminated its Senior Secured Credit Agreement (the “Prior Senior Secured Credit Agreement”) and used $96.3 million of the net proceeds from the Convertible Notes to repay all outstanding amounts owed thereunder. On June 27, 2019 (the “Prior Closing Date”), the Company entered into the Prior Senior Secured Credit Agreement with PNC Bank National Association (“PNC”), as administrative agent, and the lenders party thereto. The Prior Senior Secured Credit Agreement provided for a $100.0 million revolving credit facility (the “Prior Revolving Credit Facility”), a $100.0 million term loan facility (the “Prior Term Loan Facility”), and a $50.0 million delayed draw term loan (the “Prior Delayed Draw Term Loan”). Borrowings under the Prior Senior Secured Credit Agreement 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 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 ranged 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 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 LIBOR loans. The Company had previously entered into an interest rate swap agreements to hedge against changes in the variable rate for a portion of our long term debt. See Note 8. Derivative Instruments and Hedging Activities, for more information on these instruments. The Prior Revolving Credit Facility included a $10.0 million swing loan sublimit, with swing loans that bore interest at the alternate base rate plus the applicable margin. Any principal outstanding under the Prior Revolving Credit Facility was due and payable on June 27, 2024 or such earlier date as the obligations under the Prior Senior Secured Credit Agreement became due and payable pursuant to the terms of the Prior Senior Secured Credit Agreement. No amounts were outstanding under the Prior Revolving Credit Facility as of December 31, 2019. Principal payments on the Prior Term Loan Facility were due on the last day of each fiscal quarter 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 Prior Senior Secured Credit Agreement become due and payable pursuant to the terms of the Prior Senior Secured Credit Agreement. On December 31, 2019, the Company had current outstanding borrowings under the Prior Term Loan Facility of approximately $5.0 million, and long-term outstanding borrowings of approximately $91.8 million, net of unamortized debt issuance costs of $0.7 million. In association with the early termination of the debt, the Company incurred a loss on the extinguishment of debt of $1.4 million. In addition to paying interest on outstanding principal under the Prior Senior Secured Credit Agreement, the Company was required to pay a commitment fee in respect of the unutilized portion of the commitments under the Prior Revolving Credit Facility and the Prior Delayed Draw Term Loan. The commitment fee rate ranged from 0.15% to 0.35% depending on NeoGenomics’ Consolidated Leverage Ratio. The Company also paid customary letter of credit and agency fees. The Prior Term Loan Facility contained 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 was required to meet certain maximum leverage ratios and fixed charge coverage ratios as of the end of each fiscal quarter. The Prior Term Loan Facility 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, and (ii) 100% of net cash proceeds from certain issuances or incurrences of additional debt. 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 4.91% as of June 30, 2020 and 4.64% as of December 31, 2019. Maturities of Long-Term Debt Maturities of long-term debt as of June 30, 2020 are summarized as follows (in thousands): 1.25% Convertible Senior Notes Financing Obligations Total Long-Term Debt Remainder of 2020 $ — $ 2,543 $ 2,543 2021 — 2,880 2,880 2022 — 895 895 2023 — 51 51 2024 — — — 2025 165,164 — 165,164 Total Debt 165,164 6,369 171,533 Less: Current portion of long-term debt — (4,458) (4,458) Less: Debt issuance costs (621) — (621) Long-term debt, net $ 164,543 $ 1,911 $ 166,454

Derivative Instruments and Hedg

Derivative Instruments and Hedging Activities	6 Months Ended
	Jun. 30, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative Instruments and Hedging Activities	Derivative Instruments and Hedging Activities As of June 30, 2020 , the Company did not have any outstanding interest rate swap agreements. In June of 2018, the Company entered into an interest rate swap agreement to reduce the Company ’ s exposure to interest rate fluctuations on the Company ’ s variable rate debt obligations. This derivative financial instrument was accounted for at fair value as a cash flow hedge to effectively modify the Company’s exposure to interest rate risk by converting a portion of its prior floating rate debt to a fixed rate obligation, thus reducing the impact of interest rate changes on interest expense. Under the swap agreement, the Company received a variable rate of interest based on LIBOR and paid a fixed rate of interest. The following table summarizes the previous interest rate swap agreement. June 2018 Hedge Notional Amount $ 70 million Effective Date June 29, 2018 Index One month LIBOR Maturity December 31, 2021 Fixed Rate 2.98 % As discussed in Note 7, concurrently with the closing of the Convertible Notes, the proceeds from this transaction were used to pay off all amounts outstanding under our Prior Senior Secured Credit Agreement, after which the Company had no outstanding debt with variable rate interest. On May 1, 2020, the remaining obligation to make any further payments under the swap agreement was terminated. As a result of the termination, the company paid a termination fee of $3.3 million, which is included within Loss on Termination of Cash Flow Hedge in the Consolidated Statements of Operations. As of December 31, 2019, the fair value of the derivative financial instruments included in other long-term liabilities was approximately $2.0 million. Fair value adjustments were historically recorded as an adjustment to Accumulated Other Comprehensive Income (“AOCI”), except that any gains and losses on ineffectiveness of the interest rate swap were recorded as an adjustment to “Other (income) expense, net”. In the second quarter of 2020, upon termination of the interest rate swap, the accumulated losses of $2.7 million, net of tax, related to the interest rate swap were reclassified from AOCI to Loss on Termination of Cash Flow Hedge in the Consolidated Statements of Operations.

Equity

Equity	6 Months Ended
	Jun. 30, 2020
Equity [Abstract]
Equity	Equity Underwritten Public Equity Offering On April 29, 2020, the Company entered into an underwriting agreement relating to the issuance and sale of 4,400,000 shares of the Company’s common stock, $0.001 par value per share (the “Common Stock Offering”). The price to the public in this offering was $28.50 per share and the Company sold the shares to the Underwriters at the public offering price, less underwriting discounts and commission of $1.71 per share. Under the terms of the underwriting agreement, the Company also granted the Underwriters a 30-day option to purchase up to 660,000 additional shares of Common Stock at the public offering price, less underwriting discounts and commissions. The net proceeds to the Company from the Common Stock Offering were approximately $117.9 million, after deducting underwriting discounts and commissions and estimated offering expenses payable by the Company of approximately $7.5 million. On May 29, 2020, the Underwriters partially exercised their option and on June 3, 2020, purchased an additional 351,500 shares. The net proceeds related to the option exercise were approximately $9.4 million, after deducting underwriting commissions of approximately $0.6 million.

Stock Based Compensation

Stock Based Compensation	6 Months Ended
	Jun. 30, 2020
Equity [Abstract]
Stock-based Compensation	Stock-Based Compensation The Company recorded approximately $2.6 million and $2.3 million in stock-based compensation expense for the three months ended June 30, 2020 and 2019, respectively, and approximately $4.8 million and $4.5 million in stock-based compensation expense for the six month periods ended June 30, 2020 and 2019, respectively. A summary of the stock option activity under the Company’s plans for the six months ended June 30, 2020 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2019 5,318,759 $ 9.97 Options granted 816,428 $ 28.09 Less: Options exercised 691,299 $ 7.42 Options forfeited 57,659 $ 14.72 Options outstanding at June 30, 2020 5,386,229 $ 13.01 Exercisable at June 30, 2020 3,101,808 $ 8.66 The fair value of each stock option award granted during the six months ended June 30, 2020 was estimated as of the grant date using a trinomial lattice model with the following weighted average assumptions: Six Months Ended Expected term (in years) 4.0 - 5.5 Risk-free interest rate (%) 0.7% Expected volatility (%) 39.9% - 44.5% Dividend yield (%) — Weighted average fair value/share at grant date $8.81 As of June 30, 2020, there was approximately $8.8 million of unrecognized stock-based compensation expense related to stock options that will be recognized over a weighted-average period of approximately 1.46 years. A summary of the restricted stock activity under the Company’s plans for the six months ended June 30, 2020 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2019 335,298 $ 15.75 Granted 143,177 $ 28.15 Vested (166,836) $ 12.81 Forfeited (4,919) $ 20.34 Nonvested at June 30, 2020 306,720 $ 23.06 As of June 30, 2020, there was approximately $5.0 million of unrecognized stock-based compensation expense related to restricted stock that will be recognized over a weighted-average period of approximately 1.48 years. 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.

Net (Loss) Income Per Share

Net (Loss) Income Per Share	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Net (Loss) Income Per Share	Net (Loss) Income Per Share We present both basic earnings per share (“EPS”) and diluted EPS. Basic EPS excludes potential dilution and is computed by dividing “Net income (loss)” by the weighted-average number of common shares outstanding for the period. Diluted EPS reflects the potential dilution that could occur if stock awards were exercised and if our Convertible Notes were converted. The potential dilution from stock awards is accounted for using the treasury stock method based on the average market value of our common stock. The potential dilution from conversion of the Convertible Notes is accounted for using the if-converted method, which requires that all of the shares of our common stock issuable upon conversion of the Convertible Notes will be included in the calculation of diluted EPS assuming conversion of the Convertible Notes at the beginning of the reporting period (or at time of issuance, if later). The following table shows the calculations for the three and six months ended June 30, 2020 and 2019 (in thousands, except per share amounts). Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Numerator (both basic and diluted) Net (loss) income $ (6,824) $ 1,991 $ (13,802) $ (433) Denominator Basic weighted average shares outstanding 107,887 98,297 106,209 96,734 Dilutive effect of stock options — 3,709 — — Dilutive effect of restricted stock awards — 330 — — Dilutive effect of Convertible Notes — — — — Diluted weighted average shares outstanding 107,887 102,336 106,209 96,734 Basic net (loss) income per share $ (0.06) $ 0.02 $ (0.13) $ 0.00 Diluted net (loss) income per share $ (0.06) $ 0.02 $ (0.13) $ 0.00 The following potential dilutive shares were excluded from the calculation of diluted net loss per share because their effect would be anti-dilutive for the three and six months ended June 30, 2020 and 2019: Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Stock options 2,870,633 — 2,944,330 3,404,296 Restricted stock awards 280,734 — 236,917 259,805 Convertible Notes 3,773,388 — 1,886,694 —

Related Party Transactions

Related Party Transactions	6 Months Ended
	Jun. 30, 2020
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions On May 22, 2020, the Company formed a strategic alliance with Inivata Limited, a company incorporated in England and Wales (“Inivata”), and entered into a Strategic Alliance Agreement and Laboratory Services Agreement whereas Inivata will render and perform certain laboratory testing which the Company will make available to customers. The terms and conditions of the Laboratory Services Agreement are consistent with those that would be negotiated between willing parties on an arm's length basis. Related party transactions related to Inivata for the second quarter were immaterial. In addition, the Company and Inivata entered into a line of credit agreement in the amount of $15 million (the “Line of Credit”). The Line of Credit will be available to be drawn by Inivata beginning on January 1, 2021 and has a maturity date of December 1, 2025. The Line of Credit bears interest at 0% per annum and the unpaid principal balance is payable on January 1, 2026. The Line of Credit is subject to evaluation for current expected credit losses. The impact of such losses were determined to be immaterial for the three and six months ended June 30, 2020. For further details on the investment made in Inivata, please refer to Note 13. Investment in Non-Consolidated Affiliate.

Investment in Non-consolidated

Investment in Non-consolidated Affiliate	6 Months Ended
	Jun. 30, 2020
Equity Method Investments and Joint Ventures [Abstract]
Investment in Non-Consolidated Affiliate	Investment in Non-Consolidated Affiliate In addition to the Laboratory Services Agreement and Line of Credit, as discussed in Note 12. Related Party Transactions, the Company also entered into an Investment Agreement with Inivata (the “Investment Agreement”), pursuant to which the Company acquired Series C1 Preference Shares (the “Preference Shares”) for $25 million in cash (the “Investment”) resulting in a minority interest in Inivata’s outstanding equity and an Option Deed which provides the Company with an option to purchase Inivata (the “Purchase Option”). The Investment will be made in two equal installments, with the initial installment made in May 2020 and the second installment expected to occur in August 2020. Inivata is a VIE and the Company's investment is under 20% of the total equity outstanding. The Company does not control Inivata, but does have significant influence over Inivata. However, because the Preference Shares were determined to not be in-substance common stock, and because the Preference Shares and the Purchase Option do not have readily determinable fair values, the Company has elected to measure the Preference Shares and the Purchase Option at cost, minus impairment, if any, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer. There were no such events and the Company determined no adjustments to the carrying amounts of the Preference Shares and the Purchase Option were necessary at June 30, 2020. Upon acquisition, the Investment was allocated between the Preference Shares and the Purchase Option based on the relative fair value of each and is recorded, along with associated transaction costs, as “Investment in non-consolidated affiliate” on the Consolidated Balance Sheets. At June 30, 2020, the carrying amount of the investment in non-consolidated affiliate is $13.1 million. The value is comprised of $9.6 million in Preference Shares, a $2.9 million Purchase Option and $0.6 million of associated transaction costs.

Segment Information

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

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2020
Leases [Abstract]
Schedule of Future Minimum Lease Payments under Topic 842	As of June 30, 2020, 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 2020 $ 2,984 2021 7,706 2022 5,431 2023 5,289 2024 5,349 Thereafter 37,569 Total remaining lease payments 64,328 Less: imputed interest (15,308) Total operating lease liabilities 49,020 Less: current portion (4,496) Long-term operating lease liabilities $ 44,524 Weighted-average remaining lease term (in years) 12.0 Weighted-average discount rate 4.4 %
Supplemental Operating Lease Information	The following summarizes additional supplemental data related to our operating leases (in thousands): Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Operating lease costs $ 2,172 $ 1,547 $ 4,277 $ 3,094 Six Months Ended June 30, 2020 2019 Right-of-use assets obtained in exchange for operating lease liabilities $ 24,071 $ 18,563 Cash paid for operating leases $ 3,354 $ 1,863

Revenue Recognition and Contr_2

Revenue Recognition and Contractual Adjustments (Tables)	6 Months Ended
	Jun. 30, 2020
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 as of June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, 2019 Current pharma contract assets (1) $ 1,255 $ 1,000 Long-term pharma contract assets (2) 221 153 Total pharma contract assets $ 1,476 $ 1,153 Current pharma capitalized commissions (1) $ 183 $ 133 Long-term pharma capitalized commissions (2) 820 798 Total pharma capitalized commissions $ 1,003 $ 931 Current pharma contract liabilities $ 3,570 $ 1,610 Long-term pharma contract liabilities (3) 631 1,171 Total pharma contract liabilities $ 4,201 $ 2,781 (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 June 30, Six Months Ended June 30, 2020 2019 2020 2019 Clinical Services: Client direct billing $ 45,244 $ 54,008 $ 99,535 $ 103,243 Commercial Insurance 15,148 20,894 37,142 41,802 Medicare and Medicaid 13,541 13,719 30,024 29,581 Self-Pay (49) 361 165 566 Total Clinical Services $ 73,884 $ 88,982 $ 166,866 $ 175,192 Pharma Services: 13,093 12,731 26,141 22,098 Total Revenue $ 86,977 $ 101,713 $ 193,007 $ 197,290

Acquisition (Tables)

Acquisition (Tables)	6 Months Ended
	Jun. 30, 2020
Business Combinations [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the estimated fair values of the assets acquired and liabilities assumed at the Acquisition Date (in thousands): January 10, 2020 Inventory $ 534 Prepaid assets 185 Property and equipment 16,839 Internally developed software 3,110 Customer relationships (1) 4,100 Long-term assets 346 Goodwill (2) 12,232 Total assets acquired $ 37,346 Long-term liabilities (346) Net assets acquired $ 37,000 (1) Acquired intangible assets consisted of customer relationships which are amortized over seven years. (2) The goodwill arising from the acquisition of HLI - Oncology is the amount the Company paid in excess of the fair value of the net assets acquired and was primarily for (i) the expected future cash flows derived from the existing business capabilities and infrastructure, (ii) expanding the Company's scientific expertise as a leading provider of Pharma Services and Next-Generation Sequencing and (iii) an enhanced Pharma Services menu including germline, whole exome and whole genome sequencing. All of the goodwill resulting from the acquisition of HLI - Oncology is expected to be deductible for income tax purposes.

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Classes of Intangible Assets	Intangible assets consisted of the following as of (in thousands): June 30, 2020 Amortization Cost Accumulated Net Customer Relationships 84-180 months 143,371 30,997 112,374 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,818 $ 30,997 $ 125,821 December 31, 2019 Amortization Cost Accumulated Net Trade Name 12-24 months $ 3,679 $ 3,679 $ — Non-Compete Agreement 24 months 27 27 — Customer Relationships 180 months 139,271 26,078 113,193 Trade Name - Indefinite-lived — 13,447 — 13,447 Total $ 156,424 $ 29,784 $ 126,640
Estimated Amortization Expense	The estimated amortization expense related to amortizable intangible assets for each of the four succeeding fiscal years and thereafter as of June 30, 2020 is as follows (in thousands): Remainder of 2020 $ 4,935 2021 9,870 2022 9,870 2023 9,870 2024 9,870 Thereafter 67,959 Total $ 112,374

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2020
Debt Disclosure [Abstract]
Summary of Long Term Debt	The following table summarizes the long-term debt, net at June 30, 2020 and December 31, 2019 (in thousands): June 30, 2020 December 31, 2019 1.25% Senior Convertible Notes due 2025 Principal $ 201,250 $ — Unamortized debt discount (36,086) — Unamortized debt issuance costs (621) — Total 1.25% Senior Convertible Notes due 2025 164,543 — Term loan Principal $ — $ 97,500 Unamortized debt issuance costs — (671) Total term loan — 96,829 Financing obligations 6,369 8,631 Total debt $ 170,912 $ 105,460 Less: Current portion of long-term debt — (5,000) Less: Current portion of financing obligations (4,458) (5,432) Total long-term debt, net $ 166,454 $ 95,028
Summary of Maturities of Long-Term Debt	Maturities of long-term debt as of June 30, 2020 are summarized as follows (in thousands): 1.25% Convertible Senior Notes Financing Obligations Total Long-Term Debt Remainder of 2020 $ — $ 2,543 $ 2,543 2021 — 2,880 2,880 2022 — 895 895 2023 — 51 51 2024 — — — 2025 165,164 — 165,164 Total Debt 165,164 6,369 171,533 Less: Current portion of long-term debt — (4,458) (4,458) Less: Debt issuance costs (621) — (621) Long-term debt, net $ 164,543 $ 1,911 $ 166,454

Derivative Instruments and He_2

Derivative Instruments and Hedging Activities (Tables)	6 Months Ended
	Jun. 30, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Interest Rate Derivative Instruments	The following table summarizes the previous interest rate swap agreement. June 2018 Hedge Notional Amount $ 70 million Effective Date June 29, 2018 Index One month LIBOR Maturity December 31, 2021 Fixed Rate 2.98 %

Stock Based Compensation (Table

Stock Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2020
Equity [Abstract]
Summary of Stock Option Activity	A summary of the stock option activity under the Company’s plans for the six months ended June 30, 2020 is as follows: Number of Weighted Average Exercise Price Options outstanding at December 31, 2019 5,318,759 $ 9.97 Options granted 816,428 $ 28.09 Less: Options exercised 691,299 $ 7.42 Options forfeited 57,659 $ 14.72 Options outstanding at June 30, 2020 5,386,229 $ 13.01 Exercisable at June 30, 2020 3,101,808 $ 8.66
Summary of Fair Value of Each Stock Option Award Granted	The fair value of each stock option award granted during the six months ended June 30, 2020 was estimated as of the grant date using a trinomial lattice model with the following weighted average assumptions: Six Months Ended Expected term (in years) 4.0 - 5.5 Risk-free interest rate (%) 0.7% Expected volatility (%) 39.9% - 44.5% Dividend yield (%) — Weighted average fair value/share at grant date $8.81
Summary of Restricted Stock Activity	A summary of the restricted stock activity under the Company’s plans for the six months ended June 30, 2020 is as follows: Number of Restricted Weighted Average Grant Date Fair Value Nonvested at December 31, 2019 335,298 $ 15.75 Granted 143,177 $ 28.15 Vested (166,836) $ 12.81 Forfeited (4,919) $ 20.34 Nonvested at June 30, 2020 306,720 $ 23.06

Net (Loss) Income Per Share (Ta

Net (Loss) Income Per Share (Tables)	6 Months Ended
	Jun. 30, 2020
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table shows the calculations for the three and six months ended June 30, 2020 and 2019 (in thousands, except per share amounts). Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Numerator (both basic and diluted) Net (loss) income $ (6,824) $ 1,991 $ (13,802) $ (433) Denominator Basic weighted average shares outstanding 107,887 98,297 106,209 96,734 Dilutive effect of stock options — 3,709 — — Dilutive effect of restricted stock awards — 330 — — Dilutive effect of Convertible Notes — — — — Diluted weighted average shares outstanding 107,887 102,336 106,209 96,734 Basic net (loss) income per share $ (0.06) $ 0.02 $ (0.13) $ 0.00 Diluted net (loss) income per share $ (0.06) $ 0.02 $ (0.13) $ 0.00
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	The following potential dilutive shares were excluded from the calculation of diluted net loss per share because their effect would be anti-dilutive for the three and six months ended June 30, 2020 and 2019: Three Months Ended June 30, Six Months Ended June 30, 2020 2019 2020 2019 Stock options 2,870,633 — 2,944,330 3,404,296 Restricted stock awards 280,734 — 236,917 259,805 Convertible Notes 3,773,388 — 1,886,694 —

Segment Information (Tables)

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

Nature of the Business, Basis_2

Nature of the Business, Basis of Presentation and Significant Accounting Policies - Narrative (Details)	3 Months Ended		6 Months Ended
	Jun. 30, 2020USD ($)	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)segment	Jun. 30, 2019USD ($)
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%
COVID-19, grant income	$ 7,900,000	$ 0	$ 7,900,000	$ 0
COVID-19, deferred social security payroll tax	$ 2,100,000		$ 2,100,000

Recently Adopted and Issued A_2

Recently Adopted and Issued Accounting Guidance - Narrative (Details) $ in Millions	Jun. 30, 2020USD ($)
Accounting Changes and Error Corrections [Abstract]
Restricted cash	$ 36

Leases - Narrative (Details)

Leases - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2020USD ($)
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	$ 34.6
Florida
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	25
Florida | Leasehold Improvements
Lessee, Lease, Description [Line Items]
Minimum lease payments for leases executed but not yet commenced	$ 17
Minimum
Lessee, Lease, Description [Line Items]
Operating lease, remaining lease term	1 year
Lease renewal term	1 year
Maximum
Lessee, Lease, Description [Line Items]
Operating lease, remaining lease term	15 years
Lease renewal term	5 years

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Lease Payments (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Leases [Abstract]
Remainder of 2020	$ 2,984
2021	7,706
2022	5,431
2023	5,289
2024	5,349
Thereafter	37,569
Total remaining lease payments	64,328
Less: imputed interest	(15,308)
Total operating lease liabilities	49,020
Less: current portion	(4,496)	$ (3,381)
Long-term portion of operating leases	$ 44,524	$ 24,034
Weighted-average remaining lease term (in years)	12 years
Weighted-average discount rate	4.40%

Leases - Summary of Supplementa

Leases - Summary of Supplemental Lease Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Leases [Abstract]
Operating lease costs	$ 2,172	$ 1,547	$ 4,277	$ 3,094
Right-of-use assets obtained in exchange for operating lease liabilities			24,071	18,563
Cash paid for operating leases			$ 3,354	$ 1,863

Revenue Recognition and Contr_3

Revenue Recognition and Contractual Adjustments - Narrative (Details) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2020USD ($)	Jun. 30, 2020USD ($)segment
Revenue from Contract with Customer [Abstract]
Number of operating segments | segment		2
Increase in Pharma contract assets		$ 0.3
Pharma contract asset, increase (as a percent)	28.00%	28.00%
Increase in pharma contract liabilities		$ 1.4
Increase in pharma contract liabilities (as a percent)		51.00%
Pharma contract liability, revenue recognized	$ 0.4	$ 1.6
Amortization of contract commissions	$ 0.1	$ 0.3

Revenue Recognition and Contr_4

Revenue Recognition and Contractual Adjustments - Contract Assets and Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Contract with Customer, Asset, Net [Abstract]
Current pharma contract assets	$ 1,255	$ 1,000
Long-term pharma contract assets	221	153
Total pharma contract assets	1,476	1,153
Capitalized Contract Cost [Abstract]
Current pharma capitalized commissions	183	133
Long-term pharma capitalized commissions	820	798
Total pharma capitalized commissions	1,003	931
Contract with Customer, Liability [Abstract]
Current pharma contract liabilities	3,570	1,610
Long-term pharma contract liabilities	631	1,171
Total pharma contract liabilities	$ 4,201	$ 2,781

Revenue Recognition and Contr_5

Revenue Recognition and Contractual Adjustments - Disaggregation of Revenue (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	$ 86,977	$ 101,713	$ 193,007	$ 197,290
Clinical Services
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	73,884	88,982	166,866	175,192
Clinical Services | Client direct billing
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	45,244	54,008	99,535	103,243
Clinical Services | Commercial Insurance
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	15,148	20,894	37,142	41,802
Clinical Services | Medicare and Medicaid
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	13,541	13,719	30,024	29,581
Clinical Services | Self-Pay
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	(49)	361	165	566
Pharma Services
Revenue, Initial Application Period Cumulative Effect Transition [Line Items]
Total revenue	$ 13,093	$ 12,731	$ 26,141	$ 22,098

Acquisition - Narrative (Detail

Acquisition - Narrative (Details) - Human Longevity, Inc. - USD ($) $ in Millions	Jan. 10, 2020	Jun. 30, 2020	Jun. 30, 2020
Business Acquisition [Line Items]
Payment for business acquisition	$ 37
Acquisition and integration costs		$ 0.1	$ 1.4

Acquisition - Schedule of Provi

Acquisition - Schedule of Provisional Information (Details) - USD ($) $ in Thousands	Jan. 10, 2020	Jun. 30, 2020	Dec. 31, 2019
Business Acquisition [Line Items]
Goodwill		$ 210,833	$ 198,601
Human Longevity, Inc.
Business Acquisition [Line Items]
Inventory	$ 534
Prepaid assets	185
Property and equipment	16,839
Long-term assets	346
Goodwill	12,232
Total assets acquired	37,346
Long-term liabilities	(346)
Net assets acquired	37,000
Customer Relationships | Human Longevity, Inc.
Business Acquisition [Line Items]
Intangible assets	$ 4,100
Customer relationships, useful life	7 years
Internally Developed Software | Human Longevity, Inc.
Business Acquisition [Line Items]
Intangible assets	$ 3,110

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Narrative (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	$ 210,833		$ 210,833		$ 198,601
Amortization of intangibles	$ 2,500	$ 2,500	$ 4,919	$ 5,102

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Classes of Intangible Assets (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Mar. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
Finite-Lived Intangible Assets [Line Items]
Total cost of intangibles		$ 156,818	$ 156,424
Accumulated Amortization		30,997	29,784
Finite-lived intangibles, net		112,374
Intangible assets, net		125,821	126,640
Trade Name - Indefinite-lived
Finite-Lived Intangible Assets [Line Items]
Trade Name - Indefinite-lived		13,447	13,447
Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Cost		143,371	139,271
Accumulated Amortization		30,997	26,078
Finite-lived intangibles, net		$ 112,374	113,193
Trade Name - Indefinite-lived
Finite-Lived Intangible Assets [Line Items]
Cost			3,679
Accumulated Amortization			3,679
Finite-lived intangibles, net			0
Non-Compete Agreement
Finite-Lived Intangible Assets [Line Items]
Amortization Period	24 months
Cost			27
Accumulated Amortization			27
Finite-lived intangibles, net			$ 0
Minimum | Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period		84 months
Minimum | Trade Name - Indefinite-lived
Finite-Lived Intangible Assets [Line Items]
Amortization Period	12 months
Maximum | Customer Relationships
Finite-Lived Intangible Assets [Line Items]
Amortization Period	180 months	180 months
Maximum | Trade Name - Indefinite-lived
Finite-Lived Intangible Assets [Line Items]
Amortization Period	24 months

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Estimated Amortization Expense (Detail) $ in Thousands	Jun. 30, 2020USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2020	$ 4,935
2021	9,870
2022	9,870
2023	9,870
2024	9,870
Thereafter	67,959
Total	$ 112,374

Debt - Summary of Long Term Deb

Debt - Summary of Long Term Debt (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Unamortized debt issuance costs	$ (621)
Financing obligations	6,369	$ 8,631
Total debt	170,912	105,460
Less:  Current portion of long-term debt	0	(5,000)
Less: Current portion of financing obligations	(4,458)	(5,432)
Total long-term debt, net	166,454	95,028
Convertible Debt | 1.25% Convertible Senior Notes
Debt Instrument [Line Items]
Principal	201,250	0
Unamortized debt discount	(36,086)	0
Unamortized debt issuance costs	(621)	0
Long-term debt	164,543	0
Term Loan Facility
Debt Instrument [Line Items]
Principal	0	97,500
Unamortized debt issuance costs	0	(671)
Long-term debt	0	96,829
Financing Obligations
Debt Instrument [Line Items]
Less: Current portion of financing obligations	$ (4,458)	$ (5,432)

Debt - Narrative (Detail)

Debt - Narrative (Detail)	May 04, 2020USD ($)$ / sharesRate	Jun. 27, 2019USD ($)	Jun. 30, 2020USD ($)$ / sharesRate	Jun. 30, 2019USD ($)	Jun. 30, 2020USD ($)day$ / sharesRate	Jun. 30, 2019USD ($)	Dec. 31, 2019USD ($)
Line of Credit Facility [Line Items]
Issuance of common stock, net					$ 5,469,000	$ 8,061,000
Principal amount priced to investors (as a percent) | Rate			98.00%		98.00%
Conversion price on applicable trading day (as a percent)					130.00%
Ownership of convertible notes (as a percent)					25.00%
Proceeds from issuance of convertible debt, net of issuance costs					$ 194,376,000	0
Current secured debt			$ 0		0		$ 5,000,000
Long-term portion of term loan, net			0		0		91,829,000
Debt issuance costs			621,000		621,000
Loss on extinguishment of debt			$ 1,400,000	$ 1,018,000	$ 1,400,000	$ 1,018,000	$ 1,400,000
Debt instrument, weighted average interest rates			4.91%		4.91%		4.64%
Common Stock
Line of Credit Facility [Line Items]
Share price (in dollars per share) | $ / shares			$ 30.98		$ 30.98
Convertible Debt
Line of Credit Facility [Line Items]
Proceeds from issuance of convertible debt, net of issuance costs	$ 96,300,000
Term Loan Facility
Line of Credit Facility [Line Items]
Debt issuance costs			$ 0		$ 0		$ 671,000
1.25% Convertible Senior Notes | Convertible Debt
Line of Credit Facility [Line Items]
Debt instrument, face amount	$ 201,300,000
Stated interest rate (as a percent) | Rate	1.25%
Discount on principal amount (as a percent) | Rate	97.00%
Discount on shares			6,900,000		$ 6,900,000
Threshold trading days | day					20
Consecutive trading days | day					30
Conversion price on applicable trading day (as a percent)					130.00%
Convertible Notes, conversion ratio | Rate	2751.98%
Convertible Notes, conversion price (in dollars per share) | $ / shares	$ 36.34
Interest expense, contractual coupon interest			400,000		$ 400,000
Interest expense, accretion of debt discount			900,000		900,000
Interest expense, amortization of debt issuance costs			19,100		$ 19,100
Effective interest rate on Convertible Notes (as a percent)					5.50%
Carrying amount of equity component			21,600,000		$ 21,600,000
Debt issuance costs			$ 621,000		$ 621,000		$ 0
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
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%
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
Over-Allotment Option
Line of Credit Facility [Line Items]
Issuance of common stock, net					$ 194,400,000

Debt - Schedule of Maturities o

Debt - Schedule of Maturities of Long Term Debt (Detail) - USD ($) $ in Thousands	Jun. 30, 2020	Dec. 31, 2019
Long-term Debt, by Current and Noncurrent [Abstract]
Less:  Current portion of long-term debt	$ 0	$ (5,000)
Unamortized debt issuance costs	(621)
Finance Obligations
Less:  Current portion of long-term debt	(4,458)	(5,432)
Long-term debt, net	1,911	3,199
Total Long-Term Debt
Remainder of 2020	2,543
2021	2,880
2022	895
2023	51
2024	0
2025	165,164
Total Debt	171,533
Less:  Current portion of long-term debt	(4,458)
Total long-term debt, net	166,454	95,028
Term Loan And Revolving Credit Facility
Long-term Debt, by Current and Noncurrent [Abstract]
Remainder of 2020	0
2021	0
2022	0
2023	0
2024	0
2025	165,164
Total Debt	165,164
Less:  Current portion of long-term debt	0
Unamortized debt issuance costs	(621)
Long-term debt, net	164,543
Financing Obligations
Finance Obligations
Remainder of 2020	2,543
2021	2,880
2022	895
2023	51
2024	0
2025	0
Total Debt	6,369
Less:  Current portion of long-term debt	(4,458)	$ (5,432)
Long-term debt, net	$ 1,911

Derivative Instruments and He_3

Derivative Instruments and Hedging Activities (Details) - USD ($)	May 01, 2020	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019	Dec. 31, 2019
Derivative [Line Items]
Termination fee				$ 3,317,000	$ 0
Loss on derivative reclassified from AOCI to earnings		$ 2,661,000	$ 0	2,661,000	$ 0
Previous interest rate swap agreement
Derivative [Line Items]
Termination fee	$ 3,300,000
Cash Flow Hedging | Designated as Hedging Instrument | Interest Rate Hedge June 2018
Derivative [Line Items]
Notional amount		$ 70,000,000		$ 70,000,000
Fixed interest rate		2.98%		2.98%		2.98%
Loss on derivative reclassified from AOCI to earnings		$ 2,700,000
Other Noncurrent Liabilities | Cash Flow Hedging | Designated as Hedging Instrument | Interest Rate Hedge June 2018
Derivative [Line Items]
Fair value of derivative instrument						$ 2,000,000

Equity (Details)

Equity (Details) - USD ($) $ / shares in Units, $ in Millions	Jun. 03, 2020	Apr. 29, 2020	Jun. 30, 2020	Dec. 31, 2019
Subsidiary, Sale of Stock [Line Items]
Common stock, par value (in dollars per share)			$ 0.001	$ 0.001
Common Stock Offering
Subsidiary, Sale of Stock [Line Items]
Shares sold in offering (in shares)		4,400,000
Common stock, par value (in dollars per share)		$ 0.001
Offering price per share (in dollars per share)		28.50
Underwriting discounts and commissions on sale price (in dollars per share)		$ 1.71
Option period (in days)		30 days
Net proceeds of common stock		$ 117.9
Payments of equity issue costs		$ 7.5
Over-Allotment Option
Subsidiary, Sale of Stock [Line Items]
Shares sold in offering (in shares)	351,500	660,000
Net proceeds of common stock	$ 9.4
Payments of equity issue costs	$ 0.6

Stock Based Compensation - Narr

Stock Based Compensation - Narrative (Detail) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense (gain)	$ 2,600		$ 2,300		$ 4,800	$ 4,500
Unrecognized stock-based compensation cost	8,800				$ 8,800
Unrecognized share-based compensation expense, weighted-average recognition period (in years)					1 year 5 months 15 days
Common stock issuance ESPP Plan	928	$ 796	$ 653	$ 419
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized stock-based compensation cost	$ 5,000				$ 5,000
Unrecognized share-based compensation expense, weighted-average recognition period (in years)					1 year 5 months 23 days
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)	41,058		37,255		75,388	73,287
Common stock issuance ESPP Plan	$ 200		$ 200		$ 400	$ 300

Stock Based Compensation - Summ

Stock Based Compensation - Summary of Stock Option Activity (Detail) - $ / shares	6 Months Ended
	Jun. 30, 2020
Number of shares
Beginning balance (in shares)	5,318,759
Options granted (in shares)	816,428
Less:
Options exercised (in shares)	691,299
Options canceled or expired (in shares)	57,659
Ending balance (in shares)	5,386,229
Exercisable at March 31, 2020 (in shares)	3,101,808
Weighted Average Exercise Price
Weighted average exercise price, beginning balance (in dollars per share)	$ 9.97
Weighted average exercise price, granted (in dollars per share)	28.09
Less:
Weighted average exercise price, exercised (in dollars per share)	7.42
Weighted average exercise price, canceled or expired (in dollars per share)	14.72
Weighted average exercise price, ending balance (in dollars per share)	13.01
Weighted average exercise price, exercisable, ending balance (in dollars per share)	$ 8.66

Stock Based Compensation - Fair

Stock Based Compensation - Fair Value of Each Stock Option Award Granted (Detail)	6 Months Ended
	Jun. 30, 2020$ / shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Risk-free interest rate (%)	0.70%
Dividend yield (%)	0.00%
Weighted average fair value/share at grant date (in dollars per share)	$ 8.81
Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	4 years
Expected volatility (%)	39.90%
Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (in years)	5 years 6 months
Expected volatility (%)	44.50%

Stock Based Compensation - Su_2

Stock Based Compensation - Summary of Restricted Stock Activity (Details) - Restricted Stock	6 Months Ended
	Jun. 30, 2020$ / sharesshares
Number of shares
Beginning balance (in shares) | shares	335,298
Granted (in shares) | shares	143,177
Vested (in shares) | shares	(166,836)
Forfeited (in shares) | shares	(4,919)
Ending balance (in shares) | shares	306,720
Weighted average price
Beginning balance (in dollars per share) | $ / shares	$ 15.75
Granted (in dollars per share) | $ / shares	28.15
Vested (in dollars per share) | $ / shares	12.81
Forfeited (in dollars per share) | $ / shares	20.34
Ending balance (in dollars per share) | $ / shares	$ 23.06

Net (Loss) Income Per Share - S

Net (Loss) Income Per Share - Schedule of Basic and Diluted Income (Loss) Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2020	Jun. 30, 2019
Numerator (both basic and diluted)
NET (LOSS) INCOME	$ (6,824)	$ (6,978)	$ 1,991	$ (2,424)	$ (13,802)	$ (433)
Weighted Average Number of Shares Outstanding Reconciliation [Abstract]
Basic weighted average shares outstanding (in shares)	107,887		98,297		106,209	96,734
Dilutive effect of Convertible Notes (in shares)	0		0		0	0
Diluted weighted average shares outstanding (in shares)	107,887		102,336		106,209	96,734
NET (LOSS) INCOME PER SHARE
Basic (in dollars per share)	$ (0.06)		$ 0.02		$ (0.13)	$ 0
Diluted (in dollars per share)	$ (0.06)		$ 0.02		$ (0.13)	$ 0
Stock options
Weighted Average Number of Shares Outstanding Reconciliation [Abstract]
Dilutive effect of stock options and restricted stock awards (in shares)	0		3,709		0	0
Restricted stock awards
Weighted Average Number of Shares Outstanding Reconciliation [Abstract]
Dilutive effect of stock options and restricted stock awards (in shares)	0		330		0	0

Net (Loss) Income Per Share -_2

Net (Loss) Income Per Share - Schedule of Antidilutive Shares (Details) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2020	Jun. 30, 2019	Jun. 30, 2020	Jun. 30, 2019
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	2,870,633	0	2,944,330	3,404,296
Restricted Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	280,734	0	236,917	259,805
Convertible Debt Securities
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities (in shares)	3,773,388	0	1,886,694	0

Related Party Transactions (Det

Related Party Transactions (Detail) - Affiliated Entity - Line of Credit - Strategic Alliance With Inivata Limited	May 22, 2020USD ($)
Related Party Transaction [Line Items]
Line of credit facility maximum borrowing capacity	$ 15,000,000
Stated interest rate (as a percent)	0.00%

Investment in Non-Consolidate_2

Investment in Non-Consolidated Affiliate (Details) - Variable Interest Entity, Not Primary Beneficiary $ in Millions	May 22, 2020USD ($)installment	Jun. 30, 2020USD ($)
Schedule of Equity Method Investments [Line Items]
Number of installment payments | installment	2
Carrying amount of VIE		$ 13.1
Preference Shares
Schedule of Equity Method Investments [Line Items]
Carrying amount of VIE		9.6
Purchase Option
Schedule of Equity Method Investments [Line Items]
Carrying amount of VIE		2.9
Transaction Costs
Schedule of Equity Method Investments [Line Items]
Carrying amount of VIE		$ 0.6
Affiliated Entity
Schedule of Equity Method Investments [Line Items]
Investment in minority interest	$ 25

Segment Information (Details)

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