| CASE NUMBER | I-200-24176-141495 |
| CASE STATUS | Certified - Withdraw |
| RECEIVED DATE | 6/24/2024 |
| DECISION DATE | 7/2/2024 |
| ORIGINAL CERT DATE | 7/1/2024 |
| 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 | 10/1/2024 |
| END DATE | 9/30/2027 |
| 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 | Guardian Healthcare Providers, Inc. |
| TRADE NAME DBA | Epic International Staffing |
| EMPLOYER ADDRESS1 | 105 Westpark Dr. |
| EMPLOYER ADDRESS2 | Suite 100 |
| EMPLOYER CITY | Brentwood |
| EMPLOYER STATE | TN |
| EMPLOYER POSTAL CODE | 37027 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | +18003655787 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 56131 |
| EMPLOYER POC LAST NAME | Kelly |
| EMPLOYER POC FIRST NAME | Lucas |
| EMPLOYER POC MIDDLE NAME | Garst |
| EMPLOYER POC JOB TITLE | Director, Emerging Markets |
| EMPLOYER POC ADDRESS1 | 2032 Exeter Road |
| EMPLOYER POC ADDRESS2 | Suite 2 |
| EMPLOYER POC CITY | Germantown |
| EMPLOYER POC STATE | TN |
| EMPLOYER POC POSTAL CODE | 38138 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | +19013063937 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | Luke.Kelly@epicstaffinggroup.com |
| AGENT REPRESENTING EMPLOYER | No |
| AGENT ATTORNEY LAST NAME | |
| AGENT ATTORNEY FIRST NAME | |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | |
| AGENT ATTORNEY STATE | |
| AGENT ATTORNEY POSTAL CODE | |
| AGENT ATTORNEY COUNTRY | |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | |
| LAWFIRM NAME BUSINESS NAME | |
| STATE OF HIGHEST COURT | |
| NAME OF HIGHEST STATE COURT | |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Logan Health - Conrad |
| WORKSITE ADDRESS1 | 805 Sunset Blvd. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Conrad |
| WORKSITE COUNTY | PONDERA |
| WORKSITE STATE | MT |
| WORKSITE POSTAL CODE | 59425 |
| WAGE RATE OF PAY FROM | 36.15 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $26.70 |
| 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 | 3 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-10 |
