| LCA CASE NUMBER | I-200-21097-204930 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-04-07 |
| DECISION DATE | 2021-04-14 |
| 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 | 2021-05-11 |
| END DATE | 2024-05-10 |
| 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 | Donalsonville Hospital |
| TRADE NAME DBA | Not Applicable |
| EMPLOYER ADDRESS1 | 102 Hospital Circle |
| EMPLOYER CITY | Donalsonville |
| EMPLOYER STATE | GA |
| EMPLOYER POSTAL CODE | 39845 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 12295245217 |
| NAICS CODE | 621511 |
| EMPLOYER POC LAST NAME | Hester |
| EMPLOYER POC FIRST NAME | James |
| EMPLOYER POC JOB TITLE | Laboratory Manager |
| EMPLOYER POC ADDRESS 1 | 102 Hospital Cicle |
| EMPLOYER POC CITY | Donalsonville |
| EMPLOYER POC STATE | GA |
| EMPLOYER POC POSTAL CODE | 39845 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 12295245217 |
| EMPLOYER POC EMAIL | jimmy.hester@donalsonvillehospital.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Cook |
| AGENT ATTORNEY FIRST NAME | Kevin |
| AGENT ATTORNEY MIDDLE NAME | L. |
| AGENT ATTORNEY ADDRESS1 | P.O. Box 755 |
| AGENT ATTORNEY CITY | Summerville |
| AGENT ATTORNEY STATE | SC |
| AGENT ATTORNEY POSTAL CODE | 29484 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 18439008726 |
| AGENT ATTORNEY EMAIL ADDRESS | klcook7849@verizon.net |
| LAWFIRM NAME BUSINESS NAME | Kevin L. Cook, Esq. |
| STATE OF HIGHEST COURT | NY |
|
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 102 Hospital Circle |
| LCA CASE WORKLOC1 CITY | Donalsonville |
| WORKSITE COUNTY | SEMINOLE |
| LCA CASE WORKLOC1 STATE | GA |
| WORKSITE POSTAL CODE | 39845 |
| LCA CASE WAGE RATE FROM | 54080 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 32989 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| 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 BUSINESS NAME | Not Applicable |
