| LCA CASE NUMBER | I-200-21224-517587 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-08-12 |
| DECISION DATE | 2021-08-19 |
| 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 | 2022-02-05 |
| END DATE | 2025-02-04 |
| 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 | Calhoun Liberty Hospital Association |
| TRADE NAME DBA | Calhoun Liberty Hospital |
| EMPLOYER ADDRESS1 | 20370 N.E. Burns Avenue |
| EMPLOYER CITY | Blountstown |
| EMPLOYER STATE | FL |
| EMPLOYER POSTAL CODE | 32424 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 18506745411 |
| NAICS CODE | 621511 |
| EMPLOYER POC LAST NAME | Jepsen |
| EMPLOYER POC FIRST NAME | Christinia |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 20370 N.E. Burns Avenue |
| EMPLOYER POC CITY | Blountstown |
| EMPLOYER POC STATE | FL |
| EMPLOYER POC POSTAL CODE | 32424 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 18505745411 |
| EMPLOYER POC PHONE EXT | 255 |
| EMPLOYER POC EMAIL | Christiniajepsen@calhounlibertyhospital.com |
| 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 | 20370 N. E. Burns Avenue |
| LCA CASE WORKLOC1 CITY | Blountstown |
| WORKSITE COUNTY | CALHOUN |
| LCA CASE WORKLOC1 STATE | FL |
| WORKSITE POSTAL CODE | 32424 |
| LCA CASE WAGE RATE FROM | 54080 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 45677 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER BUSINESS NAME | Not Applicable |
