Organization
HEALTHSOURCE OF OHIO INC
Active
Other names
HealthSource PCR Lab
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA MIRANDE (DIRECTOR OF CREDENTIALING)
(513) 707-4041
Entity
Organization
Contact information
Practice address
424 WARDS CORNER RD STE 110, LOVELAND, OH 45140-6943
(513) 576-5024
(513) 576-5025
Mailing address
424 WARDS CORNER RD STE 200, LOVELAND, OH 45140-6966
(513) 576-7700
(513) 576-1020
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Enumeration date
04/22/2026
Last updated
04/22/2026
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