You should need only to iterate over the result set and populate the repetition of the PV1 field. Note that you reference PV1.7 (attending provider) in your narrative, but your code references PV1.3 (assigned patient location), so adjust the below as needed to identify the proper field:

//create a copy of the request
Set newREQ = pRequest.%ConstructClone()
//now we use the copy for manipulation
Set res=##class(%ResultSet).%New("%DynamicQueryGW:SQLGW")
Set sc=res.Prepare(sqlstring,,conn)
Set sc=res.Execute()
// create a repetition counter
Set cnt=1
While res.Next()
{
    Set RET = res.GetData(2)
    //Modify the segment
    //Reference the correct repetition for the current result set member
    set res = newREQ.SetValueAt(RET,"PV1:3("_cnt_")")
    //Increment the repetition counter
    Set cnt=cnt+1
}
Set sc=res.Close()
Set sc=conn.Disconnect()

The appropriate repetition delimiters as defined within the message schema (in this case "~") are automatically inserted.

Note that the SetValueAt() method has been modified with the assumption that you're using a consistent HL7 schema across all messages and know the correct path to the PV1 field in question. In that case the FindSegment() method should not be necessary.

ClassMethod TestObj() As %DynamicObject

{
        Set oM = {}
        Set mMode = ["down","up","click"]
        Set iter = mMode.%GetIterator()
        While iter.%GetNext(,.val)
        {
            Do oM.%Set(val,{"id":"","type":""})
        }
        Quit oM
}

USER> set oM = ##class(User.DynObj).TestObj()
USER> write oM.%ToJSON()
{"down":{"id":"","type":""},"up":{"id":"","type":""},"click":{"id":"","type":""}}
USER> zwrite oM.down.id
""
USER> zwrite oM.up.type
""
USER> set oM.click.type = "double"
USER> write oM.click.type
double
USER> write oM.%ToJSON()
{"down":{"id":"","type":""},"up":{"id":"","type":""},"click":{"id":"","type":"double"}}

This might get you closer to what you want, perhaps called from OnProcessMessage() in the service:

ClassMethod QueueGetOldest(pQueueName As %String, Output pStatus As %Status) As %String
{
    If ##class(Ens.Queue).GetCount(pQueueName) > 0
    {
        Set tStmt = ##class(%SQL.Statement).%New()                                          
        set qSC = tStmt.%PrepareClassQuery("Ens.Queue","EnumerateItem")
        Set tRS = tStmt.%Execute(pQueueName,"")                        
        Do tRS.%Next()                                                
        Set tHdrid = tRS.%Get("MessageId")
        Set tMsghdr = ##class(Ens.MessageHeader).%OpenId(tHdrid)
        Set pStatus = $$$OK
        Return tMsghdr.TimeCreated
    }
    Set pStatus = $$$ERROR($$$GeneralError,"Not found")
    Return ""
}

It returns the time created of the oldest entry in the queue, or the empty string if the queue is empty or doesn't exist.

You could create a variant that would accept a duration argument and return true/false if the duration between the current time and the time of the oldest entry exceeds that.

The tilde character ("~") has special meaning in HL7; it is normally used as the field repetition character. If it is being included in a field value as a literal character, it is often converted to an "escape sequence" so that it can be delivered to a downstream system intact rather than interpreted as a delimiter; the escape sequence for the field repetition character is \R\.

Is your intended use of the ~ character to function as a repetition delimiter, or is it actually a verbatim part of a field value?

Are you inserting these values into an EnsLib.HL7.Message object? If yes, the standard way of doing this is to first make sure the SPM field you're working with is defined as repeating in the message schema (DocType), then iterate through your list of field values to be inserted.

Assuming your message object is tMsg:

Do tMsg.SetValueAt(Modifier1,"SPM:9(1)")
Do tMsg.SetValueAt(Modifier2,"SPM:9(2)")
Do tMsg.SetValueAt(Modifier3,"SPM:9(3)")

This will automatically use the repetition separator to delimit the values in SPM field 9. Note that the path supplied for the SPM segment/field will vary based on your specific schema definition.

If it's an ObjectScript process, you would use ..SendRequestSync() or ..SendRequestAsync(), with newrequest as the request argument and the name of the downstream process or operation as the target argument. Whether you would send it asynchronously or synchronously would depend on your needs. For healthcare integration, synchronous is generally required as it maintains FIFO.

You can't modify an inbound message from a service as it will have the immutable property set; that's why you have to clone it to make changes.