extract the information in bullet form Patient Name: Date Collected: Accession Number: NAME_1 12/01/2022 R22-068317 DOB: Date Received: Requesting Facility: 11/07/1956 (66) 12/02/2022 NAME_2 Family Medicine Gender: Date Reported: Requesting Physician: CLIA#: 44D2111056 Male 12/02/2022 NAME_3 Lab Director: NAME_4 ICD Code(s): Collection Time: U07.1 10:40AM Status: Final 