| LCA CASE NUMBER | I-200-21330-726720 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-11-26 |
| DECISION DATE | 2021-12-03 |
| 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 | 2022-05-20 |
| END DATE | 2025-05-19 |
| 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 | Tioga Medical Center |
| EMPLOYER ADDRESS1 | 810 N. Welo St |
| EMPLOYER ADDRESS2 | PO Box 159 |
| EMPLOYER CITY | Tioga |
| EMPLOYER STATE | ND |
| EMPLOYER POSTAL CODE | 58852 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17016643305 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Mickelsen |
| EMPLOYER POC FIRST NAME | Ryan |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 810 N. Welo St |
| EMPLOYER POC ADDRESS2 | PO Box 159 |
| EMPLOYER POC CITY | Tioga |
| EMPLOYER POC STATE | ND |
| EMPLOYER POC POSTAL CODE | 58852 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17016643305 |
| EMPLOYER POC EMAIL | rmickelsen@tiogahealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Gates |
| AGENT ATTORNEY FIRST NAME | David |
| AGENT ATTORNEY MIDDLE NAME | Rosello |
| AGENT ATTORNEY ADDRESS1 | 54 W 40th St |
| AGENT ATTORNEY CITY | New York |
| AGENT ATTORNEY STATE | NY |
| AGENT ATTORNEY POSTAL CODE | 10018 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 17189816112 |
| AGENT ATTORNEY EMAIL ADDRESS | david@dgatesesq.com |
| LAWFIRM NAME BUSINESS NAME | Law Office of David R Gates PLLC |
|
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 810 N. Welo St |
| LCA CASE WORKLOC1 CITY | Tioga |
| WORKSITE COUNTY | WILLIAMS |
| LCA CASE WORKLOC1 STATE | ND |
| WORKSITE POSTAL CODE | 58852 |
| LCA CASE WAGE RATE FROM | 25.35 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 23.63 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Employment |
