IMPACTLIFE
NPI 1821069493
Clinical Medical Laboratory in Davenport, IA

Active since January 31, 2006CLIA Certified · 3 labs
5500 LAKEVIEW PKWY, DAVENPORT, IA 52807(563) 359-5401 Get Directions Write a Review

NPPES record last updated: August 4, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 4, 2022, Aug 22, 2020 (2 updates tracked since 2020).

About Impactlife NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IMPACTLIFE (NPI 1821069493), doing business as Mississippi Valley Regional Blood Center, is a healthcare organization registered as a clinical medical laboratory in Davenport, Iowa and active in the NPI registry since January 2006. The organization holds 3 active CLIA laboratory certificates, maintains 4 additional practice locations, and lists Darren Klocke, Cfo, as its authorized official.

NPPES Registry Identity

NPI1821069493
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameIMPACTLIFE
Location Address5500 LAKEVIEW PKWYDavenport, IA 52807-3481
Mailing Address5500 Lakeview ParkwayDavenport, IA 52807 · (563) 359-5401 · Fax (563) 823-4150
Organization SubpartNo
Authorized OfficialDarren KlockeCfo · (563) 823-4109
Enumeration DateJanuary 31, 2006
Last NPPES UpdateAugust 4, 20222 updates tracked since enumeration
NPPES CertifiedAugust 4, 2022
NPI 1821069493 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in IA · 16D0387118
Definition
(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.
5500 LAKEVIEW PKWY, Davenport, IA 52807

Other Names 1

Former Legal Business NameMississippi Valley Regional Blood Center

Secondary Practice Locations 4

Location 11408 W University AveUrbana, IL 61801-2341 · Phone (563) 359-5401
Location 22801 S 10th StSpringfield, IL 62703-3949 · Phone (563) 359-5401
Location 33420 Rider Trl SEarth City, MO 63045-1100 · Phone (563) 359-5401
Location 46330 Copps AveMonona, WI 53716-3719 · Phone (563) 359-5401

Other Identifiers 1

Medicaid0243113IA

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D0665212

Impactlife · Springfield, IL
Active · expires Jul 23, 2027
CLIA Number10D0665212
Laboratory TypeBlood Bank
Certificate Effective DateJuly 24, 2025
Certificate Expiration DateJuly 23, 2027
Laboratory DirectorDaniela M. Hermelin
Laboratory Phone(800) 747-5401
Laboratory LocationImpactlife2801 South 10th Street, Springfield, IL 62703
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 16D0387896

Impactlife · Davenport, IA
Active · expires Dec 11, 2026
CLIA Number16D0387896
Laboratory TypeBlood Bank
Certificate Effective DateDecember 12, 2024
Certificate Expiration DateDecember 11, 2026
Laboratory DirectorDaniela M. Hermelin
Laboratory Phone(800) 747-5401
Laboratory LocationImpactlife5500 Lakeview Parkway, Davenport, IA 52807
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 26D1063322

Impactlife · Earth City, MO
Active · expires Aug 28, 2027
CLIA Number26D1063322
Laboratory TypeBlood Bank
Certificate Effective DateAugust 29, 2025
Certificate Expiration DateAugust 28, 2027
Laboratory DirectorDaniela M. Hermelin
Laboratory Phone(800) 747-5401
Laboratory LocationImpactlife3420 Rider Trail S, Earth City, MO 63045
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Impactlife's NPI number?

The NPI number for Impactlife is 1821069493. It was assigned to this organization in the NPPES registry on January 31, 2006. The provider was formerly known as Mississippi Valley Regional Blood Center.

Where is Impactlife located?

Impactlife is located at 5500 Lakeview Pkwy, Davenport, IA 52807. The listed phone number is (563) 359-5401.

What is Impactlife's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Impactlife hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Impactlife was last updated on August 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.