| LCA CASE NUMBER | I-200-21134-316400 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-05-14 |
| DECISION DATE | 2021-05-21 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| 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 | Covenant Medical Center, Inc. |
| EMPLOYER ADDRESS1 | 3421 W. 9th Street |
| EMPLOYER CITY | Waterloo |
| EMPLOYER STATE | IA |
| EMPLOYER POSTAL CODE | 50702 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 13192728000 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Huber |
| EMPLOYER POC FIRST NAME | Timothy |
| EMPLOYER POC MIDDLE NAME | J. |
| EMPLOYER POC JOB TITLE | Chief Financial Officer |
| EMPLOYER POC ADDRESS 1 | 3421 W. 9th Street |
| EMPLOYER POC CITY | Waterloo |
| EMPLOYER POC STATE | IA |
| EMPLOYER POC POSTAL CODE | 50702 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 13192727607 |
| EMPLOYER POC EMAIL | tim.huber@mercyhealth.com |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Fortier |
| AGENT ATTORNEY FIRST NAME | Kelly |
| AGENT ATTORNEY MIDDLE NAME | M. |
| AGENT ATTORNEY ADDRESS1 | 790 N. Water Street |
| AGENT ATTORNEY ADDRESS2 | Suite 2500 |
| AGENT ATTORNEY CITY | Milwaukee |
| AGENT ATTORNEY STATE | WI |
| AGENT ATTORNEY POSTAL CODE | 53202 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14142716560 |
| AGENT ATTORNEY EMAIL ADDRESS | jlzuba@michaelbest.com |
| LAWFIRM NAME BUSINESS NAME | Michael Best & Friedrich LLP |
|
| STATE OF HIGHEST COURT | WI |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 516 S. Division Street, Suite 110 |
| WORKSITE ADDRESS2 | MercyOne Cedar Falls Family Medicine |
| LCA CASE WORKLOC1 CITY | Cedar Falls |
| WORKSITE COUNTY | BLACK HAWK |
| LCA CASE WORKLOC1 STATE | IA |
| WORKSITE POSTAL CODE | 50613 |
| LCA CASE WAGE RATE FROM | 264240 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 139755 |
| PW UNIT OF PAY | Year |
| 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 | Zuba |
| PREPARER FIRST NAME | Jessica |
| PREPARER MIDDLE INITIAL | L. |
| PREPARER BUSINESS NAME | Michael Best & Friedrich LLP |
| PREPARER EMAIL | jlzuba@michaelbest.com |
