49D2289139 CLIA NUMBER - MIRA GENETIX

Laboratory Demographics

  • CLIA Code: 49D2289139
  • Facility Name: MIRA GENETIX
  • Facility Address: 12011 ROUTE 50, SUITE 200
    FAIRFAX, VA
    ZIP 22033
  • Facility Phone: 866 324-9504
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. JOAQUIN VILLAR
  • NPI Number: 1912787144
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 49D2289139
LAB Type Independent
Facility Name MIRA GENETIX
Street 12011 ROUTE 50, SUITE 200
City FAIRFAX
State VA
ZIP 22033
Phone 866 324-9504
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 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Independent
Lab Director DR. JOAQUIN VILLAR

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