| LCA CASE NUMBER | I-200-21005-995161 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-01-05 |
| DECISION DATE | 2021-01-12 |
| 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 | True |
| LCA CASE EMPLOYMENT START DATE | 2021-05-14 |
| END DATE | 2024-05-13 |
| 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 | MARY WASHINGTON HEALTHCARE |
| TRADE NAME DBA | 2300 FALL HILL AVE., SUITE 207 |
| EMPLOYER ADDRESS1 | 2300 FALL HILL AVE., SUITE 207 |
| EMPLOYER CITY | Fredericksburg |
| EMPLOYER STATE | VA |
| EMPLOYER POSTAL CODE | 22401 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15407411399 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Burton |
| EMPLOYER POC FIRST NAME | Darla |
| EMPLOYER POC JOB TITLE | DIRECTOR, PHYSICIAN AND ASSOCIATE RECRUITMENT |
| EMPLOYER POC ADDRESS 1 | 2300 FALL HILL AVE, SUITE 207 |
| EMPLOYER POC CITY | Fredericksburg |
| EMPLOYER POC STATE | VA |
| EMPLOYER POC POSTAL CODE | 22401 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15407411399 |
| EMPLOYER POC EMAIL | darla.burton@MWHC.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Tedrow |
| AGENT ATTORNEY FIRST NAME | Klari |
| AGENT ATTORNEY MIDDLE NAME | Bauer |
| AGENT ATTORNEY ADDRESS1 | 2907 Central Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 109 |
| AGENT ATTORNEY CITY | Homewood |
| AGENT ATTORNEY STATE | AL |
| AGENT ATTORNEY POSTAL CODE | 35209 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12058718084 |
| AGENT ATTORNEY EMAIL ADDRESS | daizy@usimmigrant.net |
| LAWFIRM NAME BUSINESS NAME | Klari B. Tedrow, LLC |
|
| STATE OF HIGHEST COURT | AL |
| NAME OF HIGHEST STATE COURT | Supreme Court of Alabama |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 1001 Sam Perry Boulevard |
| LCA CASE WORKLOC1 CITY | Fredericksburg |
| WORKSITE COUNTY | SPOTSYLVANIA |
| LCA CASE WORKLOC1 STATE | VA |
| WORKSITE POSTAL CODE | 22401 |
| LCA CASE WAGE RATE FROM | 34.16 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 24.35 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| 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 | Tedrow |
| PREPARER FIRST NAME | Klari |
| PREPARER MIDDLE INITIAL | B. |
| PREPARER BUSINESS NAME | Klari B. Tedrow, LLC |
| PREPARER EMAIL | ktedrow@usimmigrant.net |
