| CASE NUMBER | I-200-24275-377519 |
| CASE STATUS | Certified |
| RECEIVED DATE | 10/1/2024 |
| DECISION DATE | 10/8/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Laboratory Technologist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/3/2025 |
| END DATE | 1/2/2028 |
| 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 | Thomas Jefferson University Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 111 S. 11th Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Philadelphia |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 19107 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 12159956000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Wallick |
| EMPLOYER POC FIRST NAME | Carly |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Immigration Specialist |
| EMPLOYER POC ADDRESS1 | 1020 Walnut Street |
| EMPLOYER POC ADDRESS2 | 5th Floor |
| EMPLOYER POC CITY | Philadelphia |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 19107 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 12155034335 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | employee-visa@jefferson.edu |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Dennis |
| AGENT ATTORNEY FIRST NAME | Kristen |
| AGENT ATTORNEY MIDDLE NAME | Repyneck |
| AGENT ATTORNEY ADDRESS1 | 101 Greenwood Ave |
| AGENT ATTORNEY ADDRESS2 | Suite 630 |
| AGENT ATTORNEY CITY | Jenkintown |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 19046 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12158853600 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | kristen@goldblumfirm.com |
| LAWFIRM NAME BUSINESS NAME | Goldblum, Pollins & Dennis, P.C. |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Pennsylvania Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 117 South 11th Street |
| WORKSITE ADDRESS2 | Room 315 |
| WORKSITE CITY | Philadelphia |
| WORKSITE COUNTY | PHILADELPHIA |
| WORKSITE STATE | PA |
| WORKSITE POSTAL CODE | 19107 |
| WAGE RATE OF PAY FROM | $79,329.69 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $54,018.00 |
| PW UNIT OF PAY | Year |
| 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 | 2025-01-03 |
