| CASE NUMBER | I-200-24124-954764 |
| CASE STATUS | Certified |
| RECEIVED DATE | 5/3/2024 |
| DECISION DATE | 5/10/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Point of Care Coordinator/Quality Assurance |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 5/13/2024 |
| END DATE | 5/12/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| EMPLOYER NAME | Mount Graham Regional Medical Center |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1600 S. 20th Avenue |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Safford |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 85546 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 19283484000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Brannon |
| EMPLOYER POC FIRST NAME | James |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Vice President, Human Resources |
| EMPLOYER POC ADDRESS1 | 1600 S. 20th Ave. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Safford |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 85546 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 19283484202 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | jbrannon@mtgraham.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Exner |
| AGENT ATTORNEY FIRST NAME | John |
| AGENT ATTORNEY MIDDLE NAME | E |
| AGENT ATTORNEY ADDRESS1 | 725 South Figueroa Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2500 |
| AGENT ATTORNEY CITY | Los Angeles |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 90017 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12133373837 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | john.exner@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis P.C. |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | California Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1600 S. 20th Avenue |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Safford |
| WORKSITE COUNTY | GRAHAM |
| WORKSITE STATE | AZ |
| WORKSITE POSTAL CODE | 85546 |
| WAGE RATE OF PAY FROM | 26.1 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $36.31 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $26.10 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | III |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Wong |
| PREPARER FIRST NAME | Sydney |
| PREPARER MIDDLE INITIAL | S |
| PREPARER BUSINESS NAME | Jackson Lewis P.C. |
| PREPARER EMAIL | Sydney.Wong@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2025-01-05 |
