| LCA CASE NUMBER | I-200-19351-200984 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2019-12-16 |
| DECISION DATE | 2019-12-23 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | MEDICAL TECHNOLOGIST |
| SOC CODE | 29-2011.00 |
| SOC TITLE | Medical and Clinical Laboratory Technologists |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-01-09 |
| END DATE | 2023-01-08 |
| 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 | CALHOUN LIBERTY HOSPITAL ASSOCIATION INC. |
| TRADE NAME DBA | CALHOUN LIBERTY HOSPITAL |
| EMPLOYER ADDRESS1 | 20370 NE BURNS AVE |
| EMPLOYER CITY | BLOUNTSTOWN |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 32424 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | +18506745411 |
| EMPLOYER PHONE EXT | 124.0 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | TAYLOR |
| EMPLOYER POC FIRST NAME | JEFF |
| EMPLOYER POC JOB TITLE | LABORATORY DIRECTOR |
| EMPLOYER POC ADDRESS1 | 20370 NE BURNS AVE |
| EMPLOYER POC CITY | BLOUNTSTOWN |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 32424 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | +18506745411 |
| EMPLOYER POC PHONE EXT | 124.0 |
| EMPLOYER POC EMAIL | jefftaylor@calhounlibertyhospital.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | MANGARON |
| AGENT ATTORNEY FIRST NAME | EDWARD |
| AGENT ATTORNEY MIDDLE NAME | NALASA |
| AGENT ATTORNEY ADDRESS1 | 2002 TIMBERLOCH PLACE |
| AGENT ATTORNEY ADDRESS2 | SUITE 200 |
| AGENT ATTORNEY CITY | THE WOODLANDS |
| AGENT ATTORNEY STATE | TX |
| AGENT ATTORNEY POSTAL CODE | 77380 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14329409985.0 |
| AGENT ATTORNEY EMAIL ADDRESS | edn.mangaron.esq@gmail.com |
| LAWFIRM NAME BUSINESS NAME | LAW OFFICE OF EDWARD N. MANGARON |
| STATE OF HIGHEST COURT | NY |
| NAME OF HIGHEST STATE COURT | COURT OF APPEALS |
| WORKSITE WORKERS | 1.0 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 20370 NE BURNS AVE |
| LCA CASE WORKLOC1 CITY | BLOUNTSTOWN |
| WORKSITE COUNTY | CALHOUN |
| LCA CASE WORKLOC1 STATE | FL |
| WORKSITE POSTAL CODE | 32424 |
| LCA CASE WAGE RATE FROM | 22.5 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 20.28 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1.0 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
