| CASE NUMBER | I-200-25066-754243 |
| CASE STATUS | Certified |
| RECEIVED DATE | 3/7/2025 |
| DECISION DATE | 3/14/2025 |
| 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 | 6/1/2025 |
| END DATE | 5/31/2028 |
| 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 | KEOKUK COUNTY HEALTH CENTER |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 23019 HIGHWAY 149 |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | SIGOURNEY |
| EMPLOYER STATE | IA |
| EMPLOYER POSTAL CODE | 52591 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16416221153 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | BELL |
| EMPLOYER POC FIRST NAME | ANNETTE |
| EMPLOYER POC MIDDLE NAME | N/A |
| EMPLOYER POC JOB TITLE | HUMAN RESOURCES/PAYROLL PROFESSIONAL |
| EMPLOYER POC ADDRESS1 | 23019 HIGHWAY 149 |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | SIGOURNEY |
| EMPLOYER POC STATE | IA |
| EMPLOYER POC POSTAL CODE | 52591 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16416221153 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | ABELL@KCHC.NET |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | PENICK |
| AGENT ATTORNEY FIRST NAME | BRIDGET |
| AGENT ATTORNEY MIDDLE NAME | RENE |
| AGENT ATTORNEY ADDRESS1 | 111 E. Grand Ave. |
| AGENT ATTORNEY ADDRESS2 | Suite 301 |
| AGENT ATTORNEY CITY | DES MOINES |
| AGENT ATTORNEY STATE | IA |
| AGENT ATTORNEY POSTAL CODE | 50309 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 15152428902 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | BPENICK@FREDLAW.COM |
| LAWFIRM NAME BUSINESS NAME | FREDRIKSON & BYRON, P.A. |
| STATE OF HIGHEST COURT | IA |
| NAME OF HIGHEST STATE COURT | IOWA SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 23019 HWY 149 |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Sigourney |
| WORKSITE COUNTY | KEOKUK |
| WORKSITE STATE | IA |
| WORKSITE POSTAL CODE | 52591 |
| WAGE RATE OF PAY FROM | $27.51 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $18.60 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| 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 | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-06-01 |
