| LCA CASE NUMBER | I-200-22052-918844 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2022-02-21 |
| DECISION DATE | 2022-02-28 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Family Medicine Physician |
| SOC CODE | 29-1062.00 |
| SOC TITLE | Family and General Practitioners |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-07-01 |
| END DATE | 2025-06-30 |
| 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 | Coffeyville Regional Medical Center Inc |
| EMPLOYER ADDRESS1 | 1400 W 4th Street |
| EMPLOYER CITY | Coffeyville |
| EMPLOYER STATE | KS |
| EMPLOYER POSTAL CODE | 67337 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 16202511200 |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Lawrence |
| EMPLOYER POC FIRST NAME | Brian |
| EMPLOYER POC JOB TITLE | President/Chief Executive Officer |
| EMPLOYER POC ADDRESS1 | 1400 W 4th Street |
| EMPLOYER POC CITY | Coffeyville |
| EMPLOYER POC STATE | KS |
| EMPLOYER POC POSTAL CODE | 67337 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 16202521519 |
| EMPLOYER POC EMAIL | [email protected] |
| AGENT REPRESENTING EMPLOYER | True |
| 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 |
| 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 | False |
| WORKSITE ADDRESS1 | 1400 W 4th Street |
| LCA CASE WORKLOC1 CITY | Coffeyville |
| WORKSITE COUNTY | MONTGOMERY |
| LCA CASE WORKLOC1 STATE | KS |
| WORKSITE POSTAL CODE | 67337 |
| LCA CASE WAGE RATE FROM | 285000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 183997 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| 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] |
