extract the information in bullet form Patient Name: Date Collected: Accession Number: NAME_1 12/27/2022 R22-069573 DOB: Date Received: Requesting Facility: 09/14/1991 (31) 12/28/2022 Medlife Urgent Care Gender: Date Reported: Requesting Physician: CLIA#: 44D2111056 Female 12/29/2022 NAME_2 Lab Director: NAME_3 ICD Code(s): Collection Time: J06.9 10:00AM Status: Final