| LCA CASE NUMBER | I-200-20119-525497 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-04-28 |
| DECISION DATE | 2021-05-03 |
| ORIGINAL CERT DATE | 2020-05-05 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Medical Laboratory Technologist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-10-15 |
| END DATE | 2023-10-14 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Antelope Memorial Hospital |
| EMPLOYER ADDRESS1 | 102 West 9th Street |
| EMPLOYER ADDRESS2 | P.O. Box 229 |
| EMPLOYER CITY | Neligh |
| EMPLOYER STATE | NE |
| EMPLOYER POSTAL CODE | 68756 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14028874151 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Becklun |
| EMPLOYER POC FIRST NAME | Megan |
| EMPLOYER POC JOB TITLE | Human Resources Director |
| EMPLOYER POC ADDRESS 1 | 102 West 9th Street |
| EMPLOYER POC ADDRESS 2 | P.O. Box 229 |
| EMPLOYER POC CITY | Neligh |
| EMPLOYER POC STATE | NE |
| EMPLOYER POC POSTAL CODE | 68756 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14028874151 |
| EMPLOYER POC EMAIL | mbecklun@amhne.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Erlbacher-Anderson |
| AGENT ATTORNEY FIRST NAME | Amy |
| AGENT ATTORNEY MIDDLE NAME | Lynn |
| AGENT ATTORNEY ADDRESS1 | 1700 Farnam Street |
| AGENT ATTORNEY ADDRESS2 | Suite 1500 |
| AGENT ATTORNEY CITY | Omaha |
| AGENT ATTORNEY STATE | NE |
| AGENT ATTORNEY POSTAL CODE | 68102 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14026368335 |
| AGENT ATTORNEY EMAIL ADDRESS | aanderson@bairdholm.com |
| LAWFIRM NAME BUSINESS NAME | Baird Holm LLP |
| STATE OF HIGHEST COURT | NE |
| NAME OF HIGHEST STATE COURT | Nebraska Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 102 West 9th Street |
| WORKSITE ADDRESS2 | P.O. Box 229 |
| LCA CASE WORKLOC1 CITY | Neligh |
| WORKSITE COUNTY | ANTELOPE |
| LCA CASE WORKLOC1 STATE | NE |
| WORKSITE POSTAL CODE | 68756 |
| LCA CASE WAGE RATE FROM | 28.42 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 22.77 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Erlbacher-Anderson |
| PREPARER FIRST NAME | Amy |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Baird Holm LLP |
| PREPARER EMAIL | aanderson@bairdholm.com |
