extract the information in bullet form Patient Name: Date Collected: Accession Number: NAME_1 12/27/2022 R22-069574 DOB: Date Received: Requesting Facility: 02/03/1957 (65) 12/28/2022 NAME_2 Family Medicine Gender: Date Reported: Requesting Physician: CLIA#: 44D2111056 Female 12/30/2022 NAME_3 Lab Director: NAME_4 ICD Code(s): Collection Time: U07.1 3:00PM Status: Final