NPI Details
IMPACTLIFE is a clinical medical laboratory in Davenport, IA. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. IMPACTLIFE NPI is 1821069493. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Mississippi Valley Regional Blood Center.
The provider's business location address is:
5500 LAKEVIEW PKWY
DAVENPORT, IA
ZIP 52807-481
Phone: (563) 359-5401
The provider's authorized official is Darren Klocke .
The authorized official title is Cfo and has the following contact phone number (563) 823-4109.
The CLIA number assigned to this NPI record is 14D2080828 - other - mobile blood collections with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 1/31/2006 and was last updated on 8/4/2022.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 291U00000X | Clinical Medical Laboratory | | 16D0387118 | IOWA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 0243113 | MEDICAID | IOWA | |
