Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Medical Group

Organization Clinical Medical Laboratory · NPI 1760658371

Providence Medical Group is a Clinical Medical Laboratory in Moraine, Ohio. Licensed in Ohio. Registered with an NPI since 2008.

Licensed in
OH
In the registry since
2008

Practice location Address checks out

2912 Springboro W Ste 203
Moraine, OH 45439-1674
Phone: (937) 297-8999
Fax: (937) 298-9673
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X · Licence 016189 (OH)

Record details

NPI number1760658371
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Medical Group
Authorized official Shirley Pfeiffer — Credentialing Coordinator · (937) 297-8999
Other names Pmg Lab
NPI enumeratedMay 3, 2008
Last updated in NPPESNovember 26, 2014
Mailing address2912 Springboro W, Suite 203, Moraine, OH 45439-1674

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