| LCA CASE NUMBER | I-200-21095-196335 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-05 |
| DECISION DATE | 2021-04-12 |
| 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 | 2021-09-27 |
| END DATE | 2024-09-26 |
| TOTAL WORKER POSITIONS | 2 |
| NEW EMPLOYMENT | 2 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Cumberland County Hospital System, Inc. |
| TRADE NAME DBA | Cape Fear Valley Medical Center |
| EMPLOYER ADDRESS1 | 1638 Owen Drive |
| EMPLOYER CITY | Fayetteville |
| EMPLOYER STATE | NC |
| EMPLOYER POSTAL CODE | 28304 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19106154000 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Stacy |
| EMPLOYER POC FIRST NAME | Pam |
| EMPLOYER POC JOB TITLE | Provider Coordinator |
| EMPLOYER POC ADDRESS 1 | 1638 Owen Drive |
| EMPLOYER POC CITY | Fayetteville |
| EMPLOYER POC STATE | NC |
| EMPLOYER POC POSTAL CODE | 28304 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19106153269 |
| EMPLOYER POC EMAIL | PStacy@capefearvalley.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Rogers |
| AGENT ATTORNEY FIRST NAME | Caela |
| AGENT ATTORNEY MIDDLE NAME | Alissa |
| AGENT ATTORNEY ADDRESS1 | 9101 Kings Parade Blvd. |
| AGENT ATTORNEY ADDRESS2 | Suite 100 |
| AGENT ATTORNEY CITY | Charlotte |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 28273 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17044969467 |
| AGENT ATTORNEY EMAIL ADDRESS | crogers@healthstaff.org |
| LAWFIRM NAME BUSINESS NAME | WorldWide HealthStaff Solutions, Ltd. |
| STATE OF HIGHEST COURT | DC |
| NAME OF HIGHEST STATE COURT | District of Columbia Court of Appeals |
| WORKSITE WORKERS | 2 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1638 Owen Drive |
| LCA CASE WORKLOC1 CITY | Fayetteville |
| WORKSITE COUNTY | CUMBERLAND |
| LCA CASE WORKLOC1 STATE | NC |
| WORKSITE POSTAL CODE | 28304 |
| LCA CASE WAGE RATE FROM | 18.55 |
| LCA CASE WAGE RATE TO | 26.39 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 18.55 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Employment |
| PREPARER LAST NAME | Rogers |
| PREPARER FIRST NAME | Caela |
| PREPARER MIDDLE INITIAL | A. |
| PREPARER BUSINESS NAME | WorldWide HealthStaff Solutions, Ltd. |
| PREPARER EMAIL | crogers@healthstaff.org |
