NPI Details
PROVIDENCE MEDICAL GROUP is a clinical medical laboratory in Moraine, OH. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. PROVIDENCE MEDICAL GROUP NPI is 1760658371. The provider is registered as an organization entity type.
The provider Is Doing Business As Pmg Lab.
The provider's business location address is:
2912 SPRINGBORO W
SUITE 203
MORAINE, OH
ZIP 45439-674
Phone: (937) 297-8999
Fax: (937) 298-9673
The provider's authorized official is Shirley A Pfeiffer .
The authorized official title is Credentialing Coordinator and has the following contact phone number (937) 297-8999.
The CLIA number assigned to this NPI record is 36D1017593 - physician office with a certificate type of Certificate of Waiver.
The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.
- Insertion of needle into vein for collection of blood sample (HCPCS:36415)
- Blood test, comprehensive group of blood chemicals (HCPCS:80053)
- Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS:85025)
- Blood test, lipids (cholesterol and triglycerides) (HCPCS:80061)
- Hemoglobin a1c level (HCPCS:83036)
- Blood test, thyroid stimulating hormone (tsh) (HCPCS:84443)
- Prostate cancer screening; prostate specific antigen test (psa) (HCPCS:G0103)
- Vitamin d-3 level (HCPCS:82306)
- Ferritin (blood protein) level (HCPCS:82728)
- Iron level (HCPCS:83540)
- Iron binding capacity (HCPCS:83550)
- Thyroxine (thyroid chemical), free (HCPCS:84439)
- Cyanocobalamin (vitamin b-12) level (HCPCS:82607)
- Blood test, basic group of blood chemicals (calcium, total) (HCPCS:80048)
- Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
- Thyroid hormone, t3 measurement, free (HCPCS:84481)
- Detection test by immunoassay with direct visual observation for influenza virus (HCPCS:87804)
- Creatine kinase (cardiac enzyme) level, total (HCPCS:82550)
- Uric acid level, blood (HCPCS:84550)
- Psa (prostate specific antigen) measurement, total (HCPCS:84153)
- Testing for presence of drug, by chemistry analyzers (HCPCS:80307)
- Red blood cell sedimentation rate, to detect inflammation, non-automated (HCPCS:85651)
- Magnesium level (HCPCS:83735)
- Folic acid level, serum (HCPCS:82746)
- Measurement c-reactive protein for detection of infection or inflammation (HCPCS:86140)
- Hepatitis c antibody screening, for individual at high risk and other covered indication(s) (HCPCS:G0472)
- Ldl cholesterol level (HCPCS:83721)
- Testosterone (hormone) level, total (HCPCS:84403)
- Lipase (fat enzyme) level (HCPCS:83690)
- Amylase (enzyme) level (HCPCS:82150)
- Urine microalbumin (protein) level (HCPCS:82043)
- Rheumatoid factor analysis (HCPCS:86430)
- Glutamyltransferase (liver enzyme) level (HCPCS:82977)
- Kidney function blood test panel (HCPCS:80069)
- Liver function blood test panel (HCPCS:80076)
- Thyroxine (thyroid chemical), total (HCPCS:84436)
- Thyroid hormone evaluation (HCPCS:84479)
- Measure of severe acute respiratory syndrome coronavirus 2 (covid-19) antibody (HCPCS:86769)
- Natriuretic peptide (heart and blood vessel protein) level (HCPCS:83880)
- Measurement c-reactive protein for detection of infection or inflammation, high sensitivity (HCPCS:86141)
- Analysis of urine, except immunoassays (HCPCS:81005)
The enumeration date for this NPI number is 5/3/2008 and was last updated on 11/26/2014.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 291U00000X | Clinical Medical Laboratory | | 016189 | OHIO | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | HO0605179 | MEDICARE PIN | | |
| 2 | 2380294 | MEDICAID | OHIO | |
