Mira Genetix

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MIRA GENETIX

Practice address

12011 Route 50 Ste 200
Fairfax, VA 22033-3310

Phone

(866) 324-9804

Fax

(866) 324-3280

NPI assigned

Oct 4, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Ray

Title

Coo

Phone

(866) 324-9804

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Metropolitan Laboratory Services Inc

  • Clinical Medical Laboratory
  • Fairfax, VA
  • NPI 1750923520

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763596800000",
    "number": "1912787144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12011 ROUTE 50 STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333310",
            "telephone_number": "866-324-9804",
            "fax_number": "866-324-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12011 ROUTE 50 STE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333310",
            "telephone_number": "866-324-9804",
            "fax_number": "866-324-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA GENETIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "866-324-9804"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Tyler Minshew, M.D.
• Mint Home Care Providers LLC
• Marshall C Mintz, MD
• Minuteclinic Diagnostic of Virginia LLC
• Alexandra Nicole Minutillo
• Heather Miranda
• Kierstin Mireku
• Ahmadshah Mirkhel, M.D.
• Kenneth R Mirkin, M.D.
• Fatima Mirza, PHD, LCSW

• Clinical Medical Laboratory in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.