| CASE NUMBER | I-200-25013-614389 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/13/2025 |
| DECISION DATE | 1/21/2025 |
| 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 | 1/27/2025 |
| END DATE | 1/24/2028 |
| TOTAL WORKER POSITIONS | 3 |
| NEW EMPLOYMENT | 3 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | INOVA HEALTH CARE SERVICES |
| TRADE NAME DBA | Inova Fairfax Medical Campus |
| EMPLOYER ADDRESS1 | 8110 Gatehouse Road |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Falls Church |
| EMPLOYER STATE | VA |
| EMPLOYER POSTAL CODE | 22042 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18556946682 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Dudzik |
| EMPLOYER POC FIRST NAME | Josh |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Director of Talent Acquisition |
| EMPLOYER POC ADDRESS1 | 8110 Gatehouse Road |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Falls Church |
| EMPLOYER POC STATE | VA |
| EMPLOYER POC POSTAL CODE | 22042 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15715620804 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | Josh.Dudzik@inova.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Johnson-Lewis |
| AGENT ATTORNEY FIRST NAME | Ann-Rose |
| AGENT ATTORNEY MIDDLE NAME | Marie |
| AGENT ATTORNEY ADDRESS1 | 9101 Kings Parade Blvd, Suite 201 |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Charlotte |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 28273 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 17044969398 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | ajohnsonlewis@healthstaff.org |
| LAWFIRM NAME BUSINESS NAME | WorldWide HealthStaff Solutions, Ltd. |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | North Carolina |
| WORKSITE WORKERS | 3 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 3300 Gallows Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Falls Church |
| WORKSITE COUNTY | FALLS CHURCH CITY |
| WORKSITE STATE | VA |
| WORKSITE POSTAL CODE | 22042 |
| WAGE RATE OF PAY FROM | $37.16 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $26.99 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| 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 Employment |
| PREPARER LAST NAME | Obiagwu |
| PREPARER FIRST NAME | Nnaemeka |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | WorldWide HealthStaff Solutions, Ltd. |
| PREPARER EMAIL | legal@healthstaff.org |
| BEGIN DATE CONVERTED | 2025-01-27 |
