| CASE NUMBER | I-200-24351-545460 |
| CASE STATUS | Certified |
| RECEIVED DATE | 12/16/2024 |
| DECISION DATE | 12/23/2024 |
| 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 | 6/15/2025 |
| END DATE | 6/14/2028 |
| 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 | Kossuth County Hospital |
| TRADE NAME DBA | Kossuth Regional Health Center |
| EMPLOYER ADDRESS1 | 1515 S. Phillips St |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Algona |
| EMPLOYER STATE | IA |
| EMPLOYER POSTAL CODE | 50511 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15152952451 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Kollmorgen |
| EMPLOYER POC FIRST NAME | Lori |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | HR Generalist |
| EMPLOYER POC ADDRESS1 | 1515 S. Phillips St. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Algona |
| EMPLOYER POC STATE | IA |
| EMPLOYER POC POSTAL CODE | 50511 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15152954645 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | Lori.Kollmorgen@mercyhealth.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Chesser |
| AGENT ATTORNEY FIRST NAME | Lori |
| AGENT ATTORNEY MIDDLE NAME | T. |
| AGENT ATTORNEY ADDRESS1 | 215 10th Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1300 |
| 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 | 15152882500 |
| AGENT ATTORNEY PHONE EXT | 7923 |
| AGENT ATTORNEY EMAIL ADDRESS | lori.chesser@dentons.com |
| LAWFIRM NAME BUSINESS NAME | Dentons Davis Brown PC |
| STATE OF HIGHEST COURT | IA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Iowa |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 1515 S. Phillips St. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Algona |
| WORKSITE COUNTY | KOSSUTH |
| WORKSITE STATE | IA |
| WORKSITE POSTAL CODE | 50511 |
| WAGE RATE OF PAY FROM | $29.43 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $37.82 |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $23.69 |
| 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 Business and Employment |
| PREPARER LAST NAME | Chesser |
| PREPARER FIRST NAME | Lori |
| PREPARER MIDDLE INITIAL | T |
| PREPARER BUSINESS NAME | Dentons Davis Brown PC |
| PREPARER EMAIL | hayden.wittrock@dentons.com |
| BEGIN DATE CONVERTED | 2025-06-15 |
