| CASE NUMBER | I-200-24180-158291 |
| CASE STATUS | Certified |
| RECEIVED DATE | 6/28/2024 |
| DECISION DATE | 7/8/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Technologist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 11/1/2024 |
| END DATE | 10/31/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Crawford County Memorial Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 100 Medical Parkway |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Denison |
| EMPLOYER STATE | IA |
| EMPLOYER POSTAL CODE | 51442 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +17122652500 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Muck |
| EMPLOYER POC FIRST NAME | Erin |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 100 Medical Parkway |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Denison |
| EMPLOYER POC STATE | IA |
| EMPLOYER POC POSTAL CODE | 51442 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +17122652506 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | emuck@ccmhia.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Stenzel |
| AGENT ATTORNEY FIRST NAME | Carla |
| AGENT ATTORNEY MIDDLE NAME | Josephine |
| AGENT ATTORNEY ADDRESS1 | 10050 Regency Cir |
| AGENT ATTORNEY ADDRESS2 | Ste 400 |
| AGENT ATTORNEY CITY | Omaha |
| AGENT ATTORNEY STATE | NE |
| AGENT ATTORNEY POSTAL CODE | 68114 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | +14023911991 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | Carla.Stenzel@jacksonlewis.com |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis PC |
| STATE OF HIGHEST COURT | NE |
| NAME OF HIGHEST STATE COURT | Nebraska Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 100 Medical Parkway |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Denison |
| WORKSITE COUNTY | CRAWFORD |
| WORKSITE STATE | IA |
| WORKSITE POSTAL CODE | 51442 |
| WAGE RATE OF PAY FROM | 25.59 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $35.83 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $21.41 |
| 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 | Montano |
| PREPARER FIRST NAME | Kayleyne |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Jackson Lewis, PC |
| PREPARER EMAIL | kayleyne.montano@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2024-01-11 |
