Organization
MIRA DX INC
Active
Other names
3primiR, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOANNE BARNES WEIDHAAS M.D., PH.D. (FOUNDER)
(424) 387-8100
Entity
Organization
Contact information
Practice address
11601 WILSHIRE BLVD., SUITE 105 PLAZA LEVEL, LOS ANGELES, CA 90025
(424) 387-8100
(424) 387-8101
Mailing address
11601 WILSHIRE BLVD., SUITE 2410, LOS ANGELES, CA 90025
(424) 387-8100
(424) 387-8101
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
07D2006340
CA
291U00000X
Clinical Medical Laboratory
CL-0672
CT
Other
Enumeration date
10/13/2010
Last updated
11/05/2024
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