| CASE NUMBER | I-200-23354-580658 |
| CASE STATUS | Withdrawn |
| RECEIVED DATE | 12/20/2023 |
| DECISION DATE | 12/20/2023 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Laboratory Technologist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 3/22/2024 |
| END DATE | 3/21/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Great Plains of Republic Co., Inc. |
| TRADE NAME DBA | Republic County Hospital |
| EMPLOYER ADDRESS1 | 2420 G Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Belleville |
| EMPLOYER STATE | KS |
| EMPLOYER POSTAL CODE | 66935 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17855276000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 6221 |
| EMPLOYER POC LAST NAME | Kelly |
| EMPLOYER POC FIRST NAME | Dan |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 2420 G Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Belleville |
| EMPLOYER POC STATE | KS |
| EMPLOYER POC POSTAL CODE | 66935 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17855276000 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | dkelly@rhospital.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Rechul-Stone |
| AGENT ATTORNEY FIRST NAME | Eliza |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 302 W. Third Street |
| AGENT ATTORNEY ADDRESS2 | Suite 710 |
| AGENT ATTORNEY CITY | Cincinnati |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 45202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 15133818472 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | eliza.stone@muimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Musillo Unkenholt, LLC |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 2420 G Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Belleville |
| WORKSITE COUNTY | REPUBLIC |
| WORKSITE STATE | KS |
| WORKSITE POSTAL CODE | 66935 |
| WAGE RATE OF PAY FROM | 25.5 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $33.00 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $22.83 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 | White |
| PREPARER FIRST NAME | Lisa |
| PREPARER MIDDLE INITIAL | M. |
| PREPARER BUSINESS NAME | Musillo Unkenholt, LLC |
| PREPARER EMAIL | lisa.white@muimmigration.com |
| BEGIN DATE CONVERTED | 2025-10-03 |
