07D2006340 CLIA NUMBER - MIRA DX, INC

Laboratory Demographics

  • CLIA Code: 07D2006340
  • Facility Name: MIRA DX, INC
  • Facility Address: 11601 WILSHIRE BLVD STE 105
    LOS ANGELES, CA
    ZIP 90025
  • Facility Phone: 424 387-8100
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. MILHAN TELATAR
  • NPI Number: 1265742100
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 07D2006340
LAB Type Independent
Facility Name MIRA DX, INC
Street 11601 WILSHIRE BLVD STE 105
City LOS ANGELES
State CA
ZIP 90025
Phone 424 387-8100
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Independent
Lab Director DR. MILHAN TELATAR

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This page was last updated on: 9/29/2025