| LCA CASE NUMBER | I-200-21085-179239 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-03-26 |
| DECISION DATE | 2021-04-02 |
| 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 | 2021-06-15 |
| END DATE | 2024-06-14 |
| 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 | Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 |
| TRADE NAME DBA | Coulee Medical Center |
| EMPLOYER ADDRESS1 | 411 Fortuyn Road |
| EMPLOYER CITY | Grand Coulee |
| EMPLOYER STATE | WA |
| EMPLOYER POSTAL CODE | 99133 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 15096331753 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Hicks |
| EMPLOYER POC FIRST NAME | Ramona |
| EMPLOYER POC JOB TITLE | Chief Executive Officer |
| EMPLOYER POC ADDRESS 1 | 411 Fortuyn Road |
| EMPLOYER POC CITY | Grand Coulee |
| EMPLOYER POC STATE | WA |
| EMPLOYER POC POSTAL CODE | 99133 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 15094498097 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Hom |
| AGENT ATTORNEY FIRST NAME | Harold |
| AGENT ATTORNEY MIDDLE NAME | Lee |
| AGENT ATTORNEY ADDRESS1 | 30200 Detroit Road |
| AGENT ATTORNEY ADDRESS2 | Suite D |
| AGENT ATTORNEY CITY | Westlake |
| AGENT ATTORNEY STATE | OH |
| AGENT ATTORNEY POSTAL CODE | 44145 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14402500400 |
| AGENT ATTORNEY EMAIL ADDRESS | [email protected] |
| LAWFIRM NAME BUSINESS NAME | Harold L. Hom Co., LPA |
| STATE OF HIGHEST COURT | OH |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | Coulee Medical Center |
| WORKSITE ADDRESS2 | 411 Fortuyn Road |
| LCA CASE WORKLOC1 CITY | Grand Coulee |
| WORKSITE COUNTY | GRANT |
| LCA CASE WORKLOC1 STATE | WA |
| WORKSITE POSTAL CODE | 99133 |
| LCA CASE WAGE RATE FROM | 27 |
| LCA CASE WAGE RATE TO | 31 |
| LCA CASE WAGE RATE UNIT | Hour |
| PREVAILING WAGE | 25.13 |
| PW UNIT OF PAY | Hour |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | Hom |
| PREPARER FIRST NAME | Harold |
| PREPARER MIDDLE INITIAL | L |
| PREPARER BUSINESS NAME | Harold L. Hom Co., LPA |
| PREPARER EMAIL | [email protected] |
