| LCA CASE NUMBER | I-200-20112-504652 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-04-21 |
| DECISION DATE | 2020-04-28 |
| 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 | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-10-01 |
| END DATE | 2023-09-30 |
| 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 | Coffey County Hospital |
| TRADE NAME DBA | Coffey Health System |
| EMPLOYER ADDRESS1 | 801 N. Fourth |
| EMPLOYER CITY | Burlington |
| EMPLOYER STATE | KS |
| EMPLOYER POSTAL CODE | 66839 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16203642121 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Thoele |
| EMPLOYER POC FIRST NAME | Theresa |
| EMPLOYER POC JOB TITLE | Chief Human Resource Officer |
| EMPLOYER POC ADDRESS1 | 801 N. Fourth |
| EMPLOYER POC CITY | Burlington |
| EMPLOYER POC STATE | KS |
| EMPLOYER POC POSTAL CODE | 66839 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16203642121 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Berner |
| AGENT ATTORNEY FIRST NAME | Donald |
| AGENT ATTORNEY MIDDLE NAME | D |
| AGENT ATTORNEY ADDRESS1 | 1551 N Waterfront Pkwy, Ste 100 |
| AGENT ATTORNEY CITY | Wichita |
| AGENT ATTORNEY STATE | KS |
| AGENT ATTORNEY POSTAL CODE | 67206 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 13162919738.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Foulston Siefkin LLP |
| STATE OF HIGHEST COURT | KS |
| NAME OF HIGHEST STATE COURT | Supreme Court of Kansas |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 801 N Fourth |
| LCA CASE WORKLOC1 CITY | Burlington |
| WORKSITE COUNTY | COFFEY |
| LCA CASE WORKLOC1 STATE | KS |
| WORKSITE POSTAL CODE | 66839 |
| LCA CASE WAGE RATE FROM | 25.0 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 19.91 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Berner |
| PREPARER FIRST NAME | Donald |
| PREPARER MIDDLE INITIAL | D |
| PREPARER BUSINESS NAME | Foulston Siefkin LLP |
| PREPARER EMAIL | [email protected] |
