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Organization

MIRA GENETIX

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL RAY (COO)
(866) 324-9804
Entity
Organization

Contact information

Practice address
12011 ROUTE 50 STE 200, FAIRFAX, VA 22033-3310
(866) 324-9804
(866) 324-3280
Mailing address
12011 ROUTE 50 STE 200, FAIRFAX, VA 22033-3310
(866) 324-9804
(866) 324-3280

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Enumeration date
10/04/2023
Last updated
11/20/2025
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