| LCA CASE NUMBER | I-200-21110-242165 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-20 |
| DECISION DATE | 2021-04-27 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Clinical Laboratory Scientist |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-06-17 |
| END DATE | 2024-06-16 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | San Benito Healthcare District |
| TRADE NAME DBA | Hazel Hawkins Memorial Hospital |
| EMPLOYER ADDRESS1 | 911 Sunset Drive |
| EMPLOYER CITY | Hollister |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 95023 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18316375711 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Vasquez |
| EMPLOYER POC FIRST NAME | Danielle |
| EMPLOYER POC JOB TITLE | Manager Employee Relations |
| EMPLOYER POC ADDRESS 1 | 911 Sunset Drive |
| EMPLOYER POC CITY | Hollister |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 95023 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18316375711 |
| EMPLOYER POC EMAIL | DVasquez@hazelhawkins.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Angeles |
| AGENT ATTORNEY FIRST NAME | Angela |
| AGENT ATTORNEY ADDRESS1 | 7095 Hollywood Blvd |
| AGENT ATTORNEY ADDRESS2 | #718 |
| AGENT ATTORNEY CITY | Hollywood |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 90028 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13235293454 |
| AGENT ATTORNEY EMAIL ADDRESS | angeleslaw@gmail.com |
| LAWFIRM NAME BUSINESS NAME | Angeles Law Offices |
| STATE OF HIGHEST COURT | CA |
|
| NAME OF HIGHEST STATE COURT | Supreme Court of California |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 911 Sunset Drive |
| LCA CASE WORKLOC1 CITY | Hollister |
| WORKSITE COUNTY | SAN BENITO |
| LCA CASE WORKLOC1 STATE | CA |
| WORKSITE POSTAL CODE | 95023 |
| LCA CASE WAGE RATE FROM | 58.16 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 36.56 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | IV |
| 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 Business |
| PREPARER LAST NAME | Angeles |
| PREPARER FIRST NAME | Angela |
| PREPARER BUSINESS NAME | Angeles Law Offices |
| PREPARER EMAIL | angeleslaw@gmail.com |
