14D2080828 CLIA NUMBER - IMPACTLIFE MISSISSIPPI VALLEY REGIONAL BLOOD CENTER

Laboratory Demographics

  • CLIA Code: 14D2080828
  • Facility Name: IMPACTLIFE MISSISSIPPI VALLEY REGIONAL BLOOD CENTER
  • Facility Address: 2801 S 10TH ST - MOBILE COLLECTIONS
    SPRINGFIELD, IL
    ZIP 62703
  • Facility Phone: 217 753-1530
  • Facility Type: Other - MOBILE BLOOD COLLECTIONS
  • Facility Type: Waiver
  • Lab Director: PETE LUX
  • NPI Number: 1821069493
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D2080828
LAB Type Other - MOBILE BLOOD COLLECTIONS
Facility Name IMPACTLIFE MISSISSIPPI VALLEY REGIONAL BLOOD CENTER
Street 2801 S 10TH ST - MOBILE COLLECTIONS
City SPRINGFIELD
State IL
ZIP 62703
Phone 217 753-1530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Other - MOBILE BLOOD COLLECTIONS
Lab Director PETE LUX

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025