MIRA DX
Medical Laboratory at Colorado Ave, Santa Monica, CA

License number
California 07D2006340
Category
Medical Laboratory
Type
Clinical Medical Laboratory
License number
California CL-0672
Category
Medical Laboratory
Type
Clinical Medical Laboratory
Owner
Name: DR. JOANNE B WEIDHAAS M.D., PH.D.
Title: FOUNDER
Phone: (203) 671-1308
Address
Address
1701 Colorado Ave ROOM 196, Santa Monica, CA 90404
National Provider ID: 1265742100
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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