| LCA CASE NUMBER | I-200-20212-744751 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-07-30 |
| DECISION DATE | 2020-08-06 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1069.03 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2021-01-01 |
| END DATE | 2023-12-31 |
| 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 | Mary Washington Medical Group Hospitalist Services, LLC |
| EMPLOYER ADDRESS1 | 2300 Fall Hill Avenue |
| EMPLOYER ADDRESS2 | Suite 509 |
| EMPLOYER CITY | Fredericksburg |
| EMPLOYER STATE | VA |
| EMPLOYER POSTAL CODE | 22401 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15407417843 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | St. Ours |
| EMPLOYER POC FIRST NAME | Phillip |
| EMPLOYER POC JOB TITLE | Director of Clinical Operations MWHC Physician Services |
| EMPLOYER POC ADDRESS1 | 2300 Fall Hill Avenue |
| EMPLOYER POC ADDRESS2 | Suite 509 |
| EMPLOYER POC CITY | Fredericksburg |
| EMPLOYER POC STATE | VA |
| EMPLOYER POC POSTAL CODE | 22401 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15407411399 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Tedrow |
| AGENT ATTORNEY FIRST NAME | Klari |
| AGENT ATTORNEY MIDDLE NAME | B. |
| AGENT ATTORNEY ADDRESS1 | care of Klari B. Tedrow |
| AGENT ATTORNEY CITY | Homewood |
| AGENT ATTORNEY STATE | AL |
| AGENT ATTORNEY POSTAL CODE | 35209 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12058718084.0 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Klari B. Tedrow, LLC |
| STATE OF HIGHEST COURT | AL |
| NAME OF HIGHEST STATE COURT | SUPREME COURT OF ALABAMA |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | Mary Washington Hospital |
| WORKSITE ADDRESS2 | 1001 Sam Perry Blvd |
| LCA CASE WORKLOC1 CITY | Fredericksburg |
| WORKSITE COUNTY | SPOTSYLVANIA |
| LCA CASE WORKLOC1 STATE | VA |
| WORKSITE POSTAL CODE | 22401 |
| LCA CASE WAGE RATE FROM | 310000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 141315.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Tedrow |
| PREPARER FIRST NAME | Klari |
| PREPARER MIDDLE INITIAL | B |
| PREPARER BUSINESS NAME | Klari B. Tedrow, LLC |
| PREPARER EMAIL | [email protected] |
