| LCA CASE NUMBER | I-200-21083-171770 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-24 |
| DECISION DATE | 2021-03-31 |
| 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 | 2021-04-20 |
| END DATE | 2024-04-19 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 1 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Trinidad Area Hospital Association |
| TRADE NAME DBA | Mt. San Rafael Hospital |
| EMPLOYER ADDRESS1 | 410 Benedicta Ave |
| EMPLOYER CITY | Trinidad |
| EMPLOYER STATE | CO |
| EMPLOYER POSTAL CODE | 81082 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17198468073 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Rogers |
| EMPLOYER POC FIRST NAME | Tammy |
| EMPLOYER POC JOB TITLE | Director of Human Resources |
| EMPLOYER POC ADDRESS 1 | 410 Benedicta Ave | |
| EMPLOYER POC CITY | Trinidad |
| EMPLOYER POC STATE | CO |
| EMPLOYER POC POSTAL CODE | 81082 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17198468073 |
| EMPLOYER POC EMAIL | trogers@msrhc.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Koren |
| AGENT ATTORNEY FIRST NAME | Gali |
| AGENT ATTORNEY ADDRESS1 | PO Box 53036 |
| AGENT ATTORNEY CITY | Irvine |
| AGENT ATTORNEY STATE | CA |
| AGENT ATTORNEY POSTAL CODE | 92619 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19496238707 |
| AGENT ATTORNEY EMAIL ADDRESS | gali@korenimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Gali Koren |
| STATE OF HIGHEST COURT | CA |
| NAME OF HIGHEST STATE COURT | Supreme Court of California |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 410 Benedicta Ave |
| LCA CASE WORKLOC1 CITY | Trinidad |
| WORKSITE COUNTY | LAS ANIMAS |
| LCA CASE WORKLOC1 STATE | CO |
| WORKSITE POSTAL CODE | 81082 |
| LCA CASE WAGE RATE FROM | 33.22 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 28.56 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | III |
| 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 | Koren |
| PREPARER FIRST NAME | Gali |
| PREPARER BUSINESS NAME | Law Offices of Gali Koren |
| PREPARER EMAIL | gali@korenimmigration.com |
