| LCA CASE NUMBER | I-200-21138-322365 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-05-18 |
| DECISION DATE | 2021-05-25 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1069.00 |
| SOC TITLE | Physicians and Surgeons, All Other |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2021-07-01 |
| END DATE | 2024-06-30 |
| 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 | 15407411400 |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Ours |
| EMPLOYER POC FIRST NAME | Phillip |
| EMPLOYER POC MIDDLE NAME | St. |
| EMPLOYER POC JOB TITLE | Director of Clinical Operations |
| EMPLOYER POC ADDRESS 1 | 2300 FALL HILL AVENUE |
| EMPLOYER POC ADDRESS 2 | 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 | 15407411400 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Tedrow |
| AGENT ATTORNEY FIRST NAME | Klari |
| AGENT ATTORNEY MIDDLE NAME | B. |
| AGENT ATTORNEY ADDRESS1 | 2907 Central Avenue |
| AGENT ATTORNEY ADDRESS2 | Suite 109 |
| AGENT ATTORNEY CITY | Homewood |
| AGENT ATTORNEY STATE | AL |
| AGENT ATTORNEY POSTAL CODE | 35209 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 12058718084 |
| 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 | False |
| WORKSITE ADDRESS1 | 101 HOSPITAL CENTER BLVD |
| LCA CASE WORKLOC1 CITY | Stafford |
| WORKSITE COUNTY | STAFFORD |
| LCA CASE WORKLOC1 STATE | VA |
| WORKSITE POSTAL CODE | 22554 |
| LCA CASE WAGE RATE FROM | 270004.8 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 141315 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 3 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| 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] |
