@superfinds888 a score of 41 is on the high end if you have an operational store and are using 3rd party apps. The Shopify speed score just imports the scoring from Google PageSpeed Insights, which is not a good tool for ecommerce sites (last I checked Amazon scored in the 50's so you're not far behind them).
To understand how the scoring works and how it can be improved: https://speedboostr.com/understanding-load-speed-on-shopify.
Many of the points you mentioned are not relevant or cannot be addressed feasibly, but a few stand out that can be fixed:
Remove unnecessary code on a high priority basis
Read through your theme files to make sure you don't have any lingering old app code (when you remove an app you still have to remove the code in your theme if they added it). Most of the time this code is in theme.liquid. If you'd like professional Shopify optimizers to do this for you you can pick up the App Analysis service here: https://speedboostr.com/services.
You can also conditionally load code (only load it on the pages where you need it). This can range from easy (conditionally loading a script file) to difficult (dissecting your theme CSS and JS and moving to separate files that only load on the intended page). My team (Speed Boostr, linked above) can advise on this after looking at your theme, but generally this is a large project with little ROI.
Compressed images
This guide shows you how to do that: https://speedboostr.com/how-to-compress-images-on-shopify/
or Defer off-screen images.
This guide shows you how to do that: https://speedboostr.com/shopify-lazy-loading
A better tool for analyzing optimization issues on Shopify is the Shopify Analyzer. It focuses on Shopify sites + uses data based on thousands of sites my team and I have analyzed and optimized.
Beware of the previous poster, OSC, they've been caught stealing, being unethical, and breaking Shopify terms of service on multiple occasions. (Details here if you're curious: https://speedboostr.com/fraudulent-shopify-partners/#copyright-osc)
