NPI Details
MIRA DX INC is a clinical medical laboratory in Los Angeles, CA. 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. MIRA DX INC NPI is 1265742100. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is 3primir, Inc..
The provider's business location address is:
11601 WILSHIRE BLVD., SUITE 105 PLAZA LEVEL
LOS ANGELES, CA
ZIP 90025
Phone: (424) 387-8100
Fax: (424) 387-8101
The provider's authorized official is Joanne Barnes Weidhaas .
The authorized official title is Founder and has the following contact phone number (424) 387-8100.
The CLIA number assigned to this NPI record is 07D2006340 - independent with a certificate type of Certificate of Accreditation.
The enumeration date for this NPI number is 10/13/2010 and was last updated on 11/5/2024.
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 | | CL-0672 | CONNECTICUT | No |
| 2 | 291U00000X | Clinical Medical Laboratory | | 07D2006340 | CALIFORNIA | Yes |
