| LCA CASE NUMBER | I-200-20091-449870 |
| STATUS | Certified - Withdrawn |
| LCA CASE SUBMIT | 2020-03-31 |
| DECISION DATE | 2021-08-24 |
| ORIGINAL CERT DATE | 2020-04-07 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | HOSPITALIST PHYSICIAN |
| SOC CODE | 29-1069 |
| SOC TITLE | PHYSICIANS AND SURGEONS, ALL OTHER |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2020-08-24 |
| END DATE | 2023-08-24 |
| 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 | Kingman Healthcare, Inc. |
| TRADE NAME DBA | Kingman Regional Medical Center |
| EMPLOYER ADDRESS1 | 3269 Stockton Hill Road |
| EMPLOYER CITY | Kingman |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 86409 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 19282634115 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Harger |
| EMPLOYER POC FIRST NAME | Anita |
| EMPLOYER POC JOB TITLE | Chief Human Resources Officer |
| EMPLOYER POC ADDRESS1 | 3269 Stockton Hill Road |
| EMPLOYER POC CITY | Kingman |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 86409 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 19282634115 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Stone |
| AGENT ATTORNEY FIRST NAME | Barbara |
| AGENT ATTORNEY MIDDLE NAME | L. |
| AGENT ATTORNEY ADDRESS1 | 3080 N. Litchfield Road |
| AGENT ATTORNEY CITY | Goodyear |
| AGENT ATTORNEY STATE | AZ |
| AGENT ATTORNEY POSTAL CODE | 85395 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 16235365750 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | 3269 N Stockton Hill Road |
| LCA CASE WORKLOC1 CITY | Kingman |
| WORKSITE COUNTY | MOHAVE |
| LCA CASE WORKLOC1 STATE | AZ |
| WORKSITE POSTAL CODE | 86409 |
| LCA CASE WAGE RATE FROM | 255000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 208000 |
| PW UNIT OF PAY | Year |
| PW OES YEAR | 7/1/2019 - 6/30/2020 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H-1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Rios |
| PREPARER FIRST NAME | Denisse |
| PREPARER BUSINESS NAME | Law Offices of Brelje and Associates, PC |
| PREPARER EMAIL | [email protected] |
