Organization
IMPACTLIFE
Active
Organization
IMPACTLIFE
Active
Other names
MIssissippi Valley Regional Blood Center
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN KLOCKE (CFO)
(563) 823-4109
Entity
Organization
Contact information
Practice address
5500 LAKEVIEW PKWY, DAVENPORT, IA 52807-3481
(563) 359-5401
Mailing address
5500 LAKEVIEW PARKWAY, DAVENPORT, IA 52807
(563) 359-5401
(563) 823-4150
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
16D0387118
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243113
—
IA
Enumeration date
01/31/2006
Last updated
08/04/2022
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