| CASE NUMBER | I-200-24057-747497 |
| CASE STATUS | Certified |
| RECEIVED DATE | 2/26/2024 |
| DECISION DATE | 3/4/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Medical Lab Technologist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 5/13/2024 |
| END DATE | 5/12/2027 |
| 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 | Elizabethtown Community Hospital |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 75 Park Street |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Elizabethtown |
| EMPLOYER STATE | NY |
| EMPLOYER POSTAL CODE | 12932 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 15188733006 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Meachem |
| EMPLOYER POC FIRST NAME | Michelle |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Vice President, Human Resources |
| EMPLOYER POC ADDRESS1 | 75 Park Street |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Elizabethtown |
| EMPLOYER POC STATE | NY |
| EMPLOYER POC POSTAL CODE | 12932 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 15188733006 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | mmeachem@ech.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Castrodale |
| AGENT ATTORNEY FIRST NAME | Alexander |
| AGENT ATTORNEY MIDDLE NAME | R. |
| AGENT ATTORNEY ADDRESS1 | 625 Liberty Ave |
| AGENT ATTORNEY ADDRESS2 | Floor 5 |
| AGENT ATTORNEY CITY | Pittsburgh |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 15222 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 14122974712 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | alex.castrodale@dentons.com |
| LAWFIRM NAME BUSINESS NAME | Dentons Cohen & Grigsby, P.C. |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | Supreme Court of Pennsylvania |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | Ticonderoga Campus |
| WORKSITE ADDRESS1 | 101 Adirondack Drive |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Ticonderoga |
| WORKSITE COUNTY | ESSEX |
| WORKSITE STATE | NY |
| WORKSITE POSTAL CODE | 12883 |
| WAGE RATE OF PAY FROM | 30 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Hour |
| PREVAILING WAGE | $24.98 |
| PW UNIT OF PAY | Hour |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| 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 | VanHoose |
| PREPARER FIRST NAME | Lindsey |
| PREPARER MIDDLE INITIAL | E |
| PREPARER BUSINESS NAME | Dentons Cohen & Grigsby, P.C. |
| PREPARER EMAIL | lindsey.vanhoose@dentons.com |
| BEGIN DATE CONVERTED | 2025-01-05 |
