| LCA CASE NUMBER | I-200-20207-735486 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-07-25 |
| DECISION DATE | 2020-07-31 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-08-04 |
| END DATE | 2023-08-03 |
| 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 | CentraCare Clinic |
| EMPLOYER ADDRESS1 | 1200 Sixth Avenue North |
| EMPLOYER CITY | St. Cloud |
| EMPLOYER STATE | MN |
| EMPLOYER POSTAL CODE | 56303 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13202407835 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Lueck |
| EMPLOYER POC FIRST NAME | Rebecca |
| EMPLOYER POC JOB TITLE | Clinical Partner Contract & Liaison Manager |
| EMPLOYER POC ADDRESS1 | 1200 Sixth Avenue North |
| EMPLOYER POC CITY | St. Cloud |
| EMPLOYER POC STATE | MN |
| EMPLOYER POC POSTAL CODE | 56303 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13202407835 |
| EMPLOYER POC EMAIL | Rebecca.Lueck@centracare.com |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Mojica |
| AGENT ATTORNEY FIRST NAME | Jenny |
| AGENT ATTORNEY MIDDLE NAME | Bouta |
| AGENT ATTORNEY ADDRESS1 | 200 South Sixth Street |
| AGENT ATTORNEY ADDRESS2 | Suite 4000 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55402 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16124927100.0 |
| AGENT ATTORNEY EMAIL ADDRESS | jmojica@fredlaw.com |
| LAWFIRM NAME BUSINESS NAME | Fredrikson & Byron PA |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 50 Centracare Drive |
| LCA CASE WORKLOC1 CITY | Long Prairie |
| WORKSITE COUNTY | TODD |
| LCA CASE WORKLOC1 STATE | MN |
| WORKSITE POSTAL CODE | 56347 |
| LCA CASE WAGE RATE FROM | 208000.0 |
| LCA CASE WAGE RATE TO | 231250.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000.0 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
