| LCA CASE NUMBER | I-200-22042-896643 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2022-02-11 |
| DECISION DATE | 2022-03-07 |
| ORIGINAL CERT DATE | 2022-02-18 |
| 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 | 2022-06-19 |
| END DATE | 2025-06-18 |
| 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 | Penn State Health Community Medical Group, LLC |
| EMPLOYER ADDRESS1 | 500 University Drive |
| EMPLOYER CITY | Hershey |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 17033 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 17175310003 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Ha |
| EMPLOYER POC FIRST NAME | Nhung |
| EMPLOYER POC JOB TITLE | Specialist, Visa Services |
| EMPLOYER POC ADDRESS1 | 100 Crystal A Drive |
| EMPLOYER POC ADDRESS2 | PO Box 604, MC CA230 |
| EMPLOYER POC CITY | Hershey |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 17033 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17175310003 |
| EMPLOYER POC EMAIL | nhungha@pennstatehealth.psu.edu |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Stock |
| AGENT ATTORNEY FIRST NAME | William |
| AGENT ATTORNEY MIDDLE NAME | A. |
| AGENT ATTORNEY ADDRESS1 | 1601 Market St. |
| AGENT ATTORNEY ADDRESS2 | Suite 2600 |
| AGENT ATTORNEY CITY | Philadelphia |
| AGENT ATTORNEY STATE | PA |
| AGENT ATTORNEY POSTAL CODE | 19103 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12158258600 |
| AGENT ATTORNEY EMAIL ADDRESS | sschiffman@klaskolaw.com |
| LAWFIRM NAME BUSINESS NAME | Klasko Immigration Law Partners, LLP |
| STATE OF HIGHEST COURT | PA |
| NAME OF HIGHEST STATE COURT | SUPREME |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | PSHCMG Colonial Park |
| WORKSITE ADDRESS2 | 4230 Crums Mill Rd, Suite 100 |
| LCA CASE WORKLOC1 CITY | Harrisburg |
| WORKSITE COUNTY | DAUPHIN |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 17112 |
| LCA CASE WAGE RATE FROM | 260000 |
| LCA CASE WAGE RATE TO | 300000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 59030 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business and Employment |