| CASE NUMBER | I-200-24292-416452 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/18/2024 |
| DECISION DATE | 10/25/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Technologist |
| SOC CODE | 29-2011.04 |
| SOC TITLE | Histotechnologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 2/3/2025 |
| END DATE | 2/2/2028 |
| 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 | Marietta Memorial Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 401 Matthew St. |
| EMPLOYER ADDRESS2 | Marietta |
| EMPLOYER CITY | Marietta |
| EMPLOYER STATE | OH |
| EMPLOYER POSTAL CODE | 45750 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17403765545 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Weaver |
| EMPLOYER POC FIRST NAME | Dan |
| EMPLOYER POC MIDDLE NAME | Albert |
| EMPLOYER POC JOB TITLE | Senior Director of Human Resources and Support Services |
| EMPLOYER POC ADDRESS1 | 401 Matthew St. |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Marietta |
| EMPLOYER POC STATE | OH |
| EMPLOYER POC POSTAL CODE | 45750 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17403765545 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | dweaver@mhsystem.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Tschugunov |
| AGENT ATTORNEY FIRST NAME | Eleanor |
| AGENT ATTORNEY MIDDLE NAME | Jane |
| AGENT ATTORNEY ADDRESS1 | 6352 Olde Eight Road |
| AGENT ATTORNEY ADDRESS2 | |
| AGENT ATTORNEY CITY | Peninsula |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 44264 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 13306074778 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | ejt@etimmlaw.com |
| LAWFIRM NAME BUSINESS NAME | The Law Office of Eleanor J. Tschuguno |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Ohio |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 401 Matthew St. |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Marietta |
| WORKSITE COUNTY | WASHINGTON |
| WORKSITE STATE | OH |
| WORKSITE POSTAL CODE | 45750 |
| WAGE RATE OF PAY FROM | $33.46 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $20.85 |
| 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 | 2025-02-03 |
